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A novel nomogram to predict futile recanalization in patients with acute ischemic stroke undergoing mechanical thrombectomy.
Lai, Cheng-Cai; Yao, Yin-Dan; Li, Xia; Liu, Ao-Fei; Li, Chen; Liu, Yun-E; Jiang, Chang-Chun; Zhang, Ying-Ying; Jin, Min; Lv, Jin; Jiang, Wei-Jian.
Afiliación
  • Lai CC; The PLA Rocket Force Characteristic Medical Center, Beijing, China.
  • Yao YD; Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing, China.
  • Li X; Department of Neurology, Ningbo No.2 Hospital, Ningbo, Zhejiang, China.
  • Liu AF; The PLA Rocket Force Characteristic Medical Center, Beijing, China.
  • Li C; Department of Neurology, Baotou Center Hospital, Baotou, China.
  • Liu YE; Neurointerventional Medical Center of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
  • Jiang CC; 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; Department of Neurology, Baotou Center Hospital, Baotou, China.
Front Neurol ; 15: 1367950, 2024.
Article en En | MEDLINE | ID: mdl-38585354
ABSTRACT
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Front Neurol Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Front Neurol Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Suiza