Table 1.
Parameters associated with futile recanalization (FR) after successful mechanical thrombectomy (MT)
| Variables | Successful MT, clinically not futile 287 (549) | FR (262/549) |
p-value |
|---|---|---|---|
| Baseline clinical parameters | |||
| Age, mean (SD) | 71 (13) | 78 (11) | < 0.001 |
| Sex, male, n (%) | 142 (49) | 131 (50) | 0.905 |
| Pre-stroke mRS, median (min–max, interquartile range) | 0 (0–2) | 2 (0–3) | < 0.001 |
| Initial NIHSS score, median (min–max) | 13 (0–41) | 18 (1–38) | < 0.001 |
| Wake-up stroke (unknown onset time), n (%) | 60 (21) | 66 (25) | 0.242 |
| Comorbidities | |||
| Arterial hypertension, n (%) | 222 (77) | 218 (83) | 0.092 |
| Diabetes mellitus, n (%) | 59 (21) | 70 (27) | 0.102 |
| Hypercholesterolemia, n (%) | 103 (36) | 95 (37) | 0.901 |
| Active smoking, n (%) | 42 (15) | 31 (12) | 0.370 |
| Previous stroke, n (%) | 44 (15) | 68 (26) | 0.002 |
| Coronary heart disease, n (%) | 71 (25) | 85 (32) | 0.049 |
| Peripheral artery disease (PAD), n (%) | 17 (6) | 24 (9) | 0.166 |
| End stage renal failure (dialysis patient), n (%) | 0 (0) | 8 (3) | 0.004 |
| Atrial fibrillation, n (%) | 137 (48) | 154 (59) | 0.008 |
| Blood levels on admission | |||
| Glucose (mg/dl), mean (SD) | 125 (40) | 113 (83) | < 0.001 |
| HbA1c [%], mean (SD) | 6.0 (30.9) | 6.3 (1.6) | 0.008 |
| Neutrophil-lymphocyte ratio, mean (SD) | 7.5 (8.5) | 10.0 (10.5) | 0.012 |
| Imaging aspects before treatment | |||
| ASPECTS on admission, median (IQR) | 9 (8–10) | 9 (7–10) | < 0.001 |
| Collateral score (Tan), median (IQR) | 3 (2–4) | 3 (2–3) | < 0.001 |
| Cerebral micoangiopathy score (Swieten), n (%) | |||
| 1 | 204 (73%) | 130 (52%) | < 0.001 |
| 2 | 47 (17%) | 73 (29%) | |
| 3 | 27 (10%) | 45 (18%) | |
| Target vessel occlusion side | |||
| Distal ICA, n (%) | 20 (7) | 12 (5) | 0.045 |
| ICA and MCA, n (%) | 24 (8) | 19 (7) | |
| Carotid‑T, n (%) | 45 (16) | 62 (24) | |
| MCA, M1-segment, n (%) | 138 (48) | 132 (50) | |
| MCA, M2-segment, n (%) | 60 (21) | 37 (14) | |
| Treatment aspects | |||
| MT only, no intravenous thrombolysis, n (%) | 110 (38) | 132 (50) | 0.005 |
| Number of thrombectomy attempts, median (IQR) | 1 (1–2) | 1.5 (1–3) | < 0.001 |
| General anesthesia during MT, n (%) | 50 (17) | 70 (27) | 0.009 |
| Stenting of extracranial ICA during MT, n (%) | 38 (14) | 35 (14) | 0.916 |
| Time from onset to initial treatment (min), mean (SD) | 173 (145) | 177 (115) | 0.765 |
| Time from hospital admission to groin puncture (min), mean (SD) | 84 (67) | 76 (35) | 0.073 |
| Time from groin puncture to final recanalization result (min), mean (SD) | 98 (74) | 105 (57) | 0.222 |
| Target vessel recanalization result (according to mTICI) | |||
| mTICI 2c | 66 (23) | 71 (27) | 0.274 |
| mTICI 3 | 221 (77) | 191 (73) | |
| Relevant variables known after initial therapy | |||
| Failure of early neurological improvement, n (%) | 13 (5) | 102 (39) | < 0.001 |
| ASPECTS follow-up, median (IQR) | 8 (7–10) | 7 (4–8) | < 0.001 |
| Intracranial hemorrhage, asymptomatic | 38 (13) | 57 (22) | 0.009 |
| ICH symptomatic | 3 (1) | 14 (5) | 0.005 |
MT mechanical thrombectomy, FR futile recanalization, mRS modified Rankin Scale, NIHSS National Institutes of Health Stroke Scale, HbA1c Hemoglobin A1c, ASPECTS Alberta Stroke Program Early CT Score, ICA Internal Carotid Artery, MCA Middle Cerebral Artery, mTICI modified Treatment In Cerebral Ischemia, ICH IntraCranial Hemorrhage, IQR InterQuartile Range, SD Standard Deviation