Relationship Between Routine Preoperative Chest CT-Based Cardiac Parameters and Recanalization After Mechanical Thrombectomy in Patients with Acute Ischemic Stroke.

Purpose: Acute ischemic stroke (AIS) is the most prevalent stroke subtype. Given the brain-heart interaction, this study investigated the association between cardiac parameters on admission routine preoperative chest CT and recanalization following thrombectomy in AIS patients. Method: We retrospectively analyzed 215 AIS patients (August 2018-June 2022) who underwent admission of none contrast chest computed tomography (NCCT) and thrombectomy within 24 h. Successful recanalization was defined as modified Treatment in Cerebral Ischemia (mTICI) score 2b-3. Multivariable logistic regression identified independent predictors. A nomogram was developed and validated using ROC, calibration, and decision curve analyses. Result: The cohort had a median age of 72 years; 63.7% were male. Hypertension (65.1%), atrial fibrillation (25.1%), and pleural effusion (56.3%) were prevalent. Successful recanalization occurred in 172 patients (80%). Independent predictors included mean arterial pressure (OR: 1.022, CI: 1.003-1.041, p = 0.025), left pulmonary artery diameter (OR: 0.838, CI: 0.733-0.958, p = 0.010), RV/A ratio (standardized) (OR:1.908, CI: 1.293-2.817, p = 0.001), septal angle (OR: 1.055, CI: 1.018-1.094, p = 0.004), and intraventricular septal angle (OR: 0.973, CI: 0.952-0.995, p = 0.015). The model achieved an AUC of 0.774 (p < 0.001) with strong calibration and net benefit. Conclusions: Cardiac parameters on routine preoperative chest CT correlate with recanalization following thrombectomy in AIS patients. The developed nomogram offers a reliable tool for clinical risk stratification.