[Analysis of factors associated with futile recanalization after endovascular treatment for acute ischemic stroke with large vessels occlusion in anterior intracranial circulation].

ABSTRACT

Objective: To analyze the related factors of futile recanalization (FR) after emergency endovascular treatment of large artery occlusion in anterior circulation. Methods: Three studies on endovascular treatment of acute anterior circulation large vessels occlusion stroke were selected, and their data were merged for retrospective analysis. Patients were divided into the FR group and favorable prognosis group according to the functional prognosis. Risk factor analysis was conducted using multivariate logistic regression. Results: A total of 1 581 patients were finally included, with 858 (48.9%) patients in favorable prognosis group and 926 (51.91%) patients in FR group. Among them, there were 939 males and 642 females, with a mean age of (65±12) years. Multivariate logistic regression analysis showed that National Institute of Health Stroke Scale (NIHSS) score (OR=1.089,95%CI1.066-1.113), puncture to recanalization time (OR=0.756, 95%CI0.586-0.971), age (OR=1.04,95%CI1.029-1.051), serum glucose (OR=1.101,95%CI1.062-1.143), systolic blood pressure (OR=1.005,95%CI1.001-1.010), passes≥3(OR=1.941,95%CI1.294-2.941)Alberta stroke program early CT (ASPECT) score (OR=0.919,95%CI0.847-0.996), occlusion site (M1 segment of middle cerebral artery, OR=0.744,95%CI0.565-0.980) and collateral circulation [(2 points, OR=0.757, 95%CI0.581-0.985); (3-4 points, adjusted OR=0.640, 95%CI 0.472-0.866)] were independent factors of FR. Conclusion: The incidence of FR in patients with large artery occlusion in anterior circulation who achieve satisfied reperfusion after endovascular treatment is high. Higher NIHSS score, longer puncture to recanalization time, older age, higher serum glucose and systolic blood pressure are risk factors, while lower ASPECTS, occlusion in cerebral middle M1 segment, better collateral circulation are protective factors.