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Original research
Predictors of futile recanalization in patients undergoing endovascular treatment in the DIRECT-MT trial
  1. Tengfei Zhou1,2,
  2. Tingyu Yi3,
  3. Tianxiao Li1,2,
  4. Liangfu Zhu1,
  5. Yucheng Li1,
  6. Zhaoshuo Li1,
  7. Meiyun Wang4,
  8. Qiang Li1,
  9. Yingkun He1,
  10. Pengfei Yang5,
  11. Yongwei Zhang5,
  12. Zifu Li5,
  13. Yongxin Zhang5,
  14. Xiaofei Ye6,
  15. Wenhuo Chen3,
  16. Shouchun Wang7,
  17. Jianmin Liu5
  18. DIRECT-MT Registry Investigators
  1. 1Department of Cerebrovascular Disease, Henan Provincial People's Hospital, Zhengzhou, Henan, China
  2. 2Department of Cerebrovascular Disease, Zhengzhou University People's Hospital, Zhengzhou, China
  3. 3Department of Neurology, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
  4. 4Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, Henan, China
  5. 5Department of Neurosurgery, Naval Medical University Changhai Hospital, Shanghai, China
  6. 6Department of Statistics, Naval Medical University, Shanghai, China
  7. 7Department of Neurology, The First Affiliated Hospital of Jilin University, Changchun, China
  1. Correspondence to Dr Tianxiao Li, Department of Cerebrovascular disease, Henan Provincial People's Hospital, Zhengzhou, Henan, China; litianxiao6666{at}126.com

Abstract

Background Futile recanalization—when patients have a successful recanalization but fail to achieve a satisfactory functional outcome— is a common phenomenon of endovascular treatment of acute ischemic stroke (AIS). The present study aimed to identify the predictors of futile recanalization in AIS patients who received endovascular treatment.

Methods This is a post-hoc analysis of the DIRECT-MT trial. Demographics, clinical characteristics, acute stroke workflow interval times, biochemical parameters, and imaging characteristics were compared between futile and meaningful recanalization groups. Multivariate analysis was performed to identify the predictors of futile recanalization.

Results Futile recanalization was observed in 277 patients. In multivariable logistic regression analysis, older age (p<0.001), higher baseline systolic blood pressure (SBP) (p=0.032), incomplete reperfusion defined by extended Thrombolysis In Cerebral Infarction (eTICI) grades (p=0.020), and larger final infarct volume (FIV) (p<0.001) were independent predictors of futile recanalization.

Conclusions Old age, high baseline SBP, incomplete reperfusion defined by eTICI, and large FIV were independent predictors of futile recanalization after endovascular therapy for AIS.

  • stroke
  • thrombectomy
  • thrombolysis

Data availability statement

Data are available in a public, open access repository. All free text entered below will be published.

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Data availability statement

Data are available in a public, open access repository. All free text entered below will be published.

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Footnotes

  • Contributors TFZ, TXL, QL, ZSL, LFZ, YCL, YKH and MYW designed the study, PFY, YXZ, ZFL, JML, YWZ,TYY, WHC and SCW conducted the trial and collected information, TFZ drafted the manuscript, all authors critically reviewed the manuscript and approved the final version.

  • Funding Supported by a grant (GN-2017R0001) from the Stroke Prevention Project of the National Health Commission of the People’s Republic of China and by the Wu Jieping Medical Foundation; the National Key R&D Program of China (2017YFE0103600), National Natural Science Foundation of China (81720108021,), Scientific and Technological Research Project of Henan Province (182102310162).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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