A novel nomogram to predict futile recanalization in patients with acute ischemic stroke undergoing mechanical thrombectomy.

Autor:	Lai CC; The PLA Rocket Force Characteristic Medical Center, Beijing, China.; Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing, China., Yao YD; Department of Neurology, Ningbo No.2 Hospital, Ningbo, Zhejiang, China., Li X; The PLA Rocket Force Characteristic Medical Center, Beijing, China.; Department of Neurology, Baotou Center Hospital, Baotou, China.; Neurointerventional Medical Center of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.; Institute of Cerebrovascular Disease in Inner Mongolia, Hohhot, Inner Mongolia, China., Liu AF; The PLA Rocket Force Characteristic Medical Center, Beijing, China., Li C; The PLA Rocket Force Characteristic Medical Center, Beijing, China., Liu YE; The PLA Rocket Force Characteristic Medical Center, Beijing, China., Jiang CC; Department of Neurology, Baotou Center Hospital, Baotou, China.; Neurointerventional Medical Center of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.; Institute of Cerebrovascular Disease in Inner Mongolia, Hohhot, Inner Mongolia, China., Zhang YY; The PLA Rocket Force Characteristic Medical Center, Beijing, China., Jin M; The PLA Rocket Force Characteristic Medical Center, Beijing, China., Lv J; The PLA Rocket Force Characteristic Medical Center, Beijing, China., Jiang WJ; The PLA Rocket Force Characteristic Medical Center, Beijing, China.
Jazyk:	angličtina
Zdroj:	Frontiers in neurology [Front Neurol] 2024 Mar 22; Vol. 15, pp. 1367950. Date of Electronic Publication: 2024 Mar 22 (Print Publication: 2024).
DOI:	10.3389/fneur.2024.1367950
Abstrakt:	Background and Objective: Futile recanalization (FR) is defined as patients with acute ischemic stroke (AIS) due to large vessel occlusion who still exhibits functional dependence although undergoing successful mechanical thrombectomy (MT). We aimed to develop and validate a simple nomogram for predicting the probability of FR after MT treatment in AIS patients. Methods: Clinical data of AIS patients in the Jrecan clinical trial in China from March 2018 to June 2019 were collected as the derivation set ( n = 162). Meanwhile, clinical data of AIS patients who underwent MT in Baotou Central Hospital and Ningbo No.2 Hospital from 2019 to 2021 were collected as the validation set ( n = 170). Multivariate logistic regression analysis was performed for all variables that had p < 0.2 in the univariate analysis in the derivation set. The independent risk factors of FR were further screened out and a nomogram was constructed. The performance of the nomogram was analyzed in the derivation and validation set using C-index, calibration plots, and decision curves. Results: No significant difference in FR rate was detected between the derivation set and the validation set [88/162 (54.32%) and 82/170 (48.23%), p = 0.267]. Multivariate logistic regression analysis showed that age ≥ 65 years old (OR = 2.096, 95%CI 1.024-4.289, p = 0.043), systolic blood pressure (SBP) ≥ 180 mmHg (OR = 5.624, 95%CI 1.141-27.717, p = 0.034), onset to recanalization time (OTR) ≥ 453 min (OR = 2.759, 95%CI 1.323-5.754, p = 0.007), 24 h intracerebral hemorrhage (ICH; OR = 4.029, 95%CI 1.844 ~ 8.803, p < 0.001) were independent risk factors for FR. The C-index of the nomogram of the derivation set and the verification set were 0.739 (95%CI 0.662~0.816) and 0.703 (95%CI 0.621~0.785), respectively. Conclusion: The nomogram composed of age, SBP, OTR, and 24 h ICH can effectively predict the probability of FR after MT in AIS patients. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Lai, Yao, Li, Liu, Li, Liu, Jiang, Zhang, Jin, Lv and Jiang.)
Databáze:	MEDLINE
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