Association between CHADS, CHADS-VASc, ATRIA, and Essen Stroke Risk Scores and Unsuccessful Recanalization after Endovascular Thrombectomy in Acute Ischemic Stroke Patients.

BACKGROUND

The CHADS, CHADS-VASc, ATRIA, and Essen scores have been developed for predicting vascular outcomes in stroke patients. We investigated the association between these stroke risk scores and unsuccessful recanalization after endovascular thrombectomy (EVT).

METHODS

From the nationwide multicenter registry (Selection Criteria in Endovascular Thrombectomy and Thrombolytic therapy (SECRET)) (Clinicaltrials.gov NCT02964052), we consecutively included 501 patients who underwent EVT. We identified pre-admission stroke risk scores in each included patient.

RESULTS

Among 501 patients who underwent EVT, 410 (81.8%) patients achieved successful recanalization (mTICI ≥ 2b). Adjusting for body mass index and < 0.1 in univariable analysis revealed the association between all stroke risk scores and unsuccessful recanalization (CHADS score: odds ratio (OR) 1.551, 95% confidence interval (CI) 1.198-2.009, = 0.001; CHADSVASc score: OR 1.269, 95% CI 1.080-1.492, = 0.004; ATRIA score: OR 1.089, 95% CI 1.011-1.174, = 0.024; and Essen score: OR 1.469, 95% CI 1.167-1.849, = 0.001). The CHADS score had the highest AUC value and differed significantly only from the Essen score (AUC of CHADS score; 0.618, 95% CI 0.554-0.681).

CONCLUSION

All stroke risk scores were associated with unsuccessful recanalization after EVT. Our study suggests that these stroke risk scores could be used to predict recanalization in stroke patients undergoing EVT.