Association of plasma VEGF with futile recanalization and intracranial angiogenesis in ischemic stroke post-endovascular treatment

• Published in: Journal of clinical neuroscience Vol. 129; p. 110831
• Main Authors: Xu, Bingdong, Wu, Zhengdong, Lin, Yingze, Liu, Yujun, Liu, Leiyuan, Zhang, Yusheng
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.11.2024
• Subjects: Acute ischemic stroke; Angiogenesis; Endovascular treatment; Futile recanalization; Vascular endothelial growth factor; Futile recanalization; Angiogenesis; Endovascular treatment; Acute ischemic stroke; Vascular endothelial growth factor
• ISSN: 0967-5868; 1532-2653; 1532-2653
• DOI: 10.1016/j.jocn.2024.110831

•Plasma VEGF levels on the third day post-EVT are strong predictors of futile recanalization in AIS patients.•The model combining VEGF levels on day 3 with other clinical factors accurately predicts futile recanalization.•VEGF elevation at multiple time points correlate significantly with angiogenesis in specific brain regions. This study aimed to compare baseline and subsequent vascular endothelial growth factor (VEGF) levels in predicting futile recanalization (FR) in acute ischemic stroke (AIS) patients undergoing endovascular treatment (EVT), and to explore the association between angiogenesis and VEGF. 84 participants were recruited, including 46 AIS in the EVT group, 20 AIS in the conventional treatment group, and 18 healthy controls. Plasma VEGF levels were measured at different time points. FR was defined as a modified Rankin scale score of 3–6 at 3 months. Multivariable analysis evaluated whether VEGF levels at different time points independently predicted FR, and receiver operating characteristic (ROC) curves assessed their predictive value. Using intracranial lesion side vascular imaging, the Maas scoring system assessed angiogenesis post-onset, with scores of 4 to 5 indicating angiogenesis. In the conventional treatment group, VEGF levels significantly decreased by day 7, while in the EVT group, reduction was observed as early as day 3. After adjusting for potential confounders, only VEGF levels on day 3 emerged as an independent predictor of FR. The combined model incorporating VEGF levels on day 3 with other factors effectively predicted FR (area under the curve = 0.916; sensitivity = 84.21 %; specificity = 100 %, P<0.0001). Plasma VEGF levels were notably higher in patients with angiogenesis in specific brain regions compared to those without angiogenesis at days 1, 3, 7, and 14 (P<0.05). VEGF levels on the 3rd day post-EVT demonstrate superior predictive value for FR. Elevated VEGF levels correlate with angiogenesis, suggesting its potential as a therapeutic target.