Determinants of Futile Recanalization and the Influence of Age After Endovascular Therapy for Acute Ischemic Stroke: A Retrospective Single-Center Cohort Study.
- 1Department of Neurology, Izmir Ataturk Training and Research Hospital, Karabaglar, 35360 Izmir, Turkey.
- 2Department of Critical Care Medicine, Izmir Ataturk Training and Research Hospital, Karabaglar, 35360 Izmir, Turkey.
- 3Department of Interventional Radiology, Izmir Ataturk Training and Research Hospital, Karabaglar, 35360 Izmir, Turkey.
Abstract
Background and Objectives: Functional independence is not always achieved after successful recanalization with endovascular therapy (EVT) for acute ischemic stroke, a phenomenon termed futile recanalization (FR). We investigated factors independently associated with FR and explored whether these associations differed by age. Materials and Methods: In this retrospective single-center study, 231 consecutive patients treated with EVT between January 2021 and December 2024 were analyzed. FR was defined as a modified Rankin Scale score > 2 at 90 days despite a modified Thrombolysis in Cerebral Infarction (mTICI) grade of 2b-3. Model 1 included all patients with successful recanalization. Model 2 was restricted to patients with anterior circulation infarction and assessable imaging and additionally included the Alberta Stroke Program Early CT Score (ASPECTS) and collateral status. Age interactions were tested. Results: Recanalization was successful in 191 patients (82.7%), of whom 114 (59.7%) had FR. In Model 1 (n = 191), admission National Institutes of Health Stroke Scale (NIHSS) score (odds ratio [OR], 1.29 per point; 95% confidence interval [CI], 1.18-1.42), admission glucose (OR, 1.01; 1.00-1.02), and puncture-to-recanalization time (OR, 1.02; 1.00-1.03) were independently associated with FR. In Model 2 (n = 146), sufficient collateral status (OR, 0.19; 0.08-0.47), ASPECTS (OR, 0.60; 0.39-0.91), NIHSS score, neutrophil-to-lymphocyte ratio (NLR), dyslipidemia, and procedural duration were independently associated with FR, whereas glucose was not retained; Model 2 had an area under the curve of 0.88. Age ≥ 80 years was not independently associated with FR; the only significant interaction was with glucose in Model 1. Conclusions: Stroke severity and procedural duration were independently associated with FR in both models. Imaging variables contributed to prognostic assessment in anterior circulation infarction. Age ≥ 80 years was not independently associated with FR. The NLR association and age-stratified findings remain exploratory.
Related
- Predictors of futile recanalization following endovascular therapy for acute anterior circulation large vessel occlusion stroke: a retrospective cohort study
- Endovascular Recanalization of Non-Acute Vertebrobasilar Occlusion in Progressive Posterior Circulation Ischemia: A Case Report
- Determinants of Serum Biotin (Vitamin B7) Concentrations: Influence of Age, Sex, and Season in a Large Population Cohort: A Retrospective Cross-Sectional Study
- Early Post‐Operative Quantitative EEG Central Beta Power Predicts Futile Recanalization After Endovascular Treatment in AIS‐LVO
- Determinants of MoCA improvement in post-ischemic stroke patients receiving acupuncture: a retrospective study
BibTeX
@article{tanriverdi2026determinants,
title = {{Determinants of Futile Recanalization and the Influence of Age After Endovascular Therapy for Acute Ischemic Stroke: A Retrospective Single-Center Cohort Study.}},
author = {Zeynep Tanriverdi and Eren Mingsar and Ibrahim Emik and Hatice Sabiha Ture and Omur Balli and Yesim Beckmann},
journal = {Medicina (Kaunas, Lithuania)},
year = {2026},
month = oct,
doi = {10.3390/medicina62102036},
url = {https://europepmc.org/article/MED/42942567},
note = {CC BY},
}
RIS
TY - JOUR
TI - Determinants of Futile Recanalization and the Influence of Age After Endovascular Therapy for Acute Ischemic Stroke: A Retrospective Single-Center Cohort Study.
AU - Zeynep Tanriverdi
AU - Eren Mingsar
AU - Ibrahim Emik
AU - Hatice Sabiha Ture
AU - Omur Balli
AU - Yesim Beckmann
PY - 2026
DA - 2026/10/21
JO - Medicina (Kaunas, Lithuania)
DO - 10.3390/medicina62102036
UR - https://europepmc.org/article/MED/42942567
AB - Background and Objectives: Functional independence is not always achieved after successful recanalization with endovascular therapy (EVT) for acute ischemic stroke, a phenomenon termed futile recanalization (FR). We investigated factors independently associated with FR and explored whether these associations differed by age. Materials and Methods: In this retrospective single-center study, 231 consecutive patients treated with EVT between January 2021 and December 2024 were analyzed. FR was defined as a modified Rankin Scale score > 2 at 90 days despite a modified Thrombolysis in Cerebral Infarction (mTICI) grade of 2b-3. Model 1 included all patients with successful recanalization. Model 2 was restricted to patients with anterior circulation infarction and assessable imaging and additionally included the Alberta Stroke Program Early CT Score (ASPECTS) and collateral status. Age interactions were tested. Results: Recanalization was successful in 191 patients (82.7%), of whom 114 (59.7%) had FR. In Model 1 (n = 191), admission National Institutes of Health Stroke Scale (NIHSS) score (odds ratio [OR], 1.29 per point; 95% confidence interval [CI], 1.18-1.42), admission glucose (OR, 1.01; 1.00-1.02), and puncture-to-recanalization time (OR, 1.02; 1.00-1.03) were independently associated with FR. In Model 2 (n = 146), sufficient collateral status (OR, 0.19; 0.08-0.47), ASPECTS (OR, 0.60; 0.39-0.91), NIHSS score, neutrophil-to-lymphocyte ratio (NLR), dyslipidemia, and procedural duration were independently associated with FR, whereas glucose was not retained; Model 2 had an area under the curve of 0.88. Age ≥ 80 years was not independently associated with FR; the only significant interaction was with glucose in Model 1. Conclusions: Stroke severity and procedural duration were independently associated with FR in both models. Imaging variables contributed to prognostic assessment in anterior circulation infarction. Age ≥ 80 years was not independently associated with FR. The NLR association and age-stratified findings remain exploratory.
SN - 1010-660X
SN - 1648-9144
ER -