Li Qinhong, Ding Chawen, Chen Boyu, Tian Zhenxuan, Chen Yujie, Li Linyu, Yu Nizhen, Song Jiaxing, Yang Jie, Guo Changwei, Huang Jiacheng, Zi Wenjie, Yang Zhao
Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China.
Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Neurol. 2025 Aug 20;16:1630438. doi: 10.3389/fneur.2025.1630438. eCollection 2025.
There is a lack of data to predict futile recanalization (FR) after endovascular treatment (EVT) in acute anterior circulation large vessel occlusion (ACLVO) with large core infarction.
This analysis included patients from a national multicenter stroke registry (November 2021 to February 2023). Patients who achieved successful recanalization (expanded Thrombolysis in Cerebral Infarction [eTICI] score ≥2b) after EVT were categorized into two groups: meaningful recanalization (MR; 90-day modified Rankin scale [mRS] 0-3) and FR (mRS 4-6). Multivariate logistic regression was performed to identify independent predictors of FR.
Among 313 patients with successful recanalization, 171 (54.6%) experienced FR, and 142 (45.4%) achieved MR. Multivariate analysis showed that a higher baseline NIH Stroke Scale score ( < 0.001), older age ( < 0.001), elevated blood glucose ( = 0.003), poor collateral circulation ( = 0.004), and incomplete recanalization (eTICI 2b vs. 3; < 0.001) were predictors of FR.
In patients with ACLVO and large core infarction, age, hyperglycemia, baseline NIHSS, poor collaterals, and incomplete recanalization were independent predictors of FR. These findings may be used to guide treatment decisions and optimize management processes.
在伴有大面积梗死核心的急性前循环大血管闭塞（ACLVO）患者中，缺乏数据来预测血管内治疗（EVT）后无效再通（FR）情况。
本分析纳入了来自全国多中心卒中登记处（2021年11月至2023年2月）的患者。在接受EVT后实现成功再通（扩展脑梗死溶栓[eTICI]评分≥2b）的患者被分为两组：有意义再通（MR；90天改良Rankin量表[mRS]评分为0 - 3）和无效再通（FR；mRS评分为4 - 6）。进行多因素逻辑回归以确定FR的独立预测因素。
在313例成功再通的患者中，171例（54.6%）出现无效再通，142例（45.4%）实现有意义再通。多因素分析显示，较高的基线美国国立卫生研究院卒中量表评分（<0.001）、年龄较大（<0.001）、血糖升高（=0.003）、侧支循环不良（=0.004）和再通不完全（eTICI 2b与3；<0.001）是无效再通的预测因素。
在伴有大面积梗死核心的ACLVO患者中，年龄、高血糖、基线NIHSS评分、侧支循环不良和再通不完全是无效再通的独立预测因素。这些发现可用于指导治疗决策并优化管理流程。
