Multivariate analysis of futile recanalization after intravascular therapy in patients with acute anterior circulation occlusion

Objective To explore the incidence and risk factors of futile recanalization after intravascular therapy in patients with acute anterior circulation occlusion.

Methods Clinical materials of 176 patients with acute anterior circulation occlusion in the registration system of the Stroke Center of the Affiliated Hospital of Nantong University from August 2015 to December 2021 were retrospectively analyzed. All the patients received intravascular therapy to successfully achieve angiographic recanalizationgrade of modified thrombolysis in cerebral infarction (mTICI) ≥ 2b, and were divided into futile recanalization group score of modified Rankin Scale (mRS) was 3 to 6 points and effective recanalization group (mRS score was 0 to 2 points) based on functional independence at 90 days after surgery. Logistic regression analysis was used to identify predictors of futile recanalization after intravascular treatment.

Results In the 176 patients, 93 patients had futile recanalization, and 83 patients had effective recanalization. There were significant differences in age, gender, atrial fibrillation, score of the National Institute of Health Stroke Scale (NIHSS) on hospital admission, ischemic time, bridging treatment and hemorrhagic transformation between the futile recanalization group and the effective recanalization group (P < 0.05). Multivariate Logistic regression analysis showed that high NIHSS score on hospital admission (OR=0.815, 95%CI, 0.760 to 0.874, P < 0.001) and ischemic time (OR=1.232, 95%CI, 1.020 to 1.488, P=0.030) were the independent predictors of futile recanalization.

Conclusion The incidence of futile recanalization after intravascular treatment is relatively high in patients with acute anterior circulation occlusion, while age, gender, atrial fibrillation, high NIHSS score on hospital admission, ischemic time, bridging treatment and hemorrhagic transformation are the risk factors for futile recanalization after intravascular treatment in AIS patients, and high NIHSS score on hospital admission and ischemic time are the independent predictive factors for futile recanalization after intravascular treatment in AIS patients.