Multiple Factors Analysis Of Futile Recanalization In Acute Ischemic Stroke Patients Treated With Mechanical Thrombectomy

Background and aim:Acute ischemic stroke seriously threatens the life and health of middle-aged and elderly people in China.It is necessary to recanalize the occlusive blood vessels as soon as possible.Mechanical thrombectomy has the advantages of rapid recanalization and longer treatment time window,but the effect of patient’s response the treatment varies greatly.This study aims to identify risk factors for poor prognosis of patients through multivariate analysis.Methods:A retrospective study was conducted in patients with acute ischemic stroke who underwent mechanical thrombectomy and reperfusion in our hospital.According to the modified Rankin Scale(m RS)score at 90 days after the operation,the patients were divided into the meaningful recanalization group(m RS<3 points,good prognosis)and the futile recanalization group(m RS≧3 points,poor prognosis).The preoperative NIHSS score and imaging indicators of the patients were used as independent variables.The occurrence of futile recanalization was used as the dependent variable.Multivariate logistic regression analysis was performed,and the receiver operating characteristic(ROC)curve was used to construct a risk prediction model.Results:A total of 74 patients were enrolled,including 21 cases(28.38%)in the meaningful recanalization group and 53 cases(71.42%)in the futile recanalization group.The two groups of patients were statistically different in age,preoperative NIHSS score,and collateral circulation ASITN/SIR score(P<0.05).Through multivariate regression analysis,patients’ age ≥ 66 years,NIHSS ≥ 16 points,and ASITN/SIR ≦ 3 grade are risk factors for futile recanalization.The ANA score scale constructed by combination of age,NIHSS score and ASITN/SIR grade can effectively predict the risk of futile recanalization(specificity 71.4%,sensitivity 81.1%).The proportion of patients with futile recanalization in ANA 0-3 groups were 16.67%,47.37%,86.84% and 90.91%,respectively.Conclusion:Old age,high preoperative NIHSS score and poor collateral circulation are the risk factors for the futile recanalization in patients with acute ischemic stroke treated by mechanical thrombectomy.The ANA score combined with age,NIHSS score and collateral ASITN/SIR grade can effectively predict the risk of futile recanalization.