Predictive effect of net water uptake on futile recanalisation in patients with acute large-vessel occlusion stroke

• Published in: Clinical radiology Vol. 79; no. 4; pp. e599 - e606
• Main Authors: Wu, H., Shi, J., Sun, X., Lu, M., Liao, A., Li, Y., Xiao, L., Zhou, C., Dong, W., Geng, Z., Yuan, L., Guo, R., Chen, M., Cheng, X., Zhu, W.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.04.2024
• Subjects: Brain Ischemia - etiology; Female; Humans; Ischemic Stroke; Retrospective Studies; Stroke - diagnostic imaging; Stroke - etiology; Stroke - surgery; Thrombectomy - methods; Treatment Outcome; Water
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2024.01.009

To determine whether net water uptake (NWU) based on automated software evaluation could predict futile recanalisation in patients with acute anterior circulation large-vessel occlusion (LVO). Patients with acute anterior circulation LVO undergoing mechanical thrombectomy in Jinling Hospital were evaluated retrospectively. NWU and other baseline data were evaluated by performing univariate and multivariate analyses. The primary endpoint was 90-day modified Rankin scale score ≥3. A nomogram to predict poor clinical outcomes was developed based on multivariate logistic regression analysis. Overall, 135 patients who underwent thrombectomy with a TICI grade ≥2b were enrolled. In multivariate logistic regression analysis, the following factors were identified as independent predictors of futile recanalisation: age (odds ratio [OR]: 1.055, 95 % confidence interval [CI]: 1.004–1.110, p=0.035), female (OR: 0.289, 95 % CI: 0.098–0.850, p=0.024), hypertension (OR: 3.182, 95 % CI: 1.160–8.728, p=0.025), high blood glucose level (OR: 1.36, 95 % CI: 1.087–1.701, p=0.007), admission National Institutes of Health Stroke Scale score (OR: 1.082, 95 % CI: 1.003–1.168, p=0.043), and NWU (OR: 1.312, 95 % CI: 1.038–1.659, p=0.023). NWU based on Alberta Stroke Program Early Computed Tomography (CT) Score (ASPECTS) could be used to predict the occurrence of futile recanalisation in patients with acute anterior circulation LVO ischaemic stroke. •Net water uptake could independently predict futile recanalization.•Nomogram visualizes the relationship between variables and clinical outcomes.•Our approach offers reduced imaging time, and is a simplified procedure.