Predictors of futile recanalization in completely recanalized middle cerebral artery occlusions: multicenter study.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Memiş Zülfikar, Gürkaş Erdem, Özdemir Atilla Özcan, Acar Bilgehan Atılgan, Ögün Muhammed Nur, Aytaç Emrah, Akpınar Çetin Kürşad, Önalan Ayşenur, Akıl Eşref, Çabalar Murat, Özkul Ayça, Görgülü Ümit, Bayındır Hasan, Mehdiyev Zaur, Delibaş Katı Şennur, Baydemir Recep, Yabalak Ahmet, Aykaç Özlem, Uysal Kocabaş Zehra, Yıldırım Serhan, Doğan Hasan, Arı Mehmet Semih, Çetiner Mustafa, Balgetir Ferhat, Eren Fettah, Eren Alper, Kızıldağ Nazım, Çenikli Utku, Şişman Bayar Aysel Büşra, Temel Ebru, Eryılmaz Halil Alper, Aksu Semanur, Saygın Uysal Emine, Gültekin Hamza, Durmaz Cebrail, Bayar Muhammet Duran, Akan Onur, Boncuk Ulaş Sena, Asil Talip
Аннотация
METHODS: We retrospectively analyzed 497 consecutive patients with middle cerebral artery (M1 or M2) occlusion who underwent EVT and achieved modified Thrombolysis in Cerebral Infarction (mTICI) 3 recanalization within 6 h of symptom onset at 19 stroke centers. FR was defined as a modified Rankin Scale (mRS) score ≥4 at 3 months. Clinical and radiological parameters were recorded, and logistic regression was used to identify independent predictors of FR.
RESULTS: Among 497 patients, 133 (26.7%) experienced FR despite complete recanalization. Independent predictors included older age (adjusted odds ratio [aOR] 1.07; 95% CI 1.03-1.10; p < 0.001), longer puncture-to-recanalization time (aOR 1.03; 95% CI 1.02-1.05; p < 0.001), higher admission C-reactive protein (aOR 1.01; 95% CI 1.00-1.02; p = 0.03), intracranial hemorrhage on 24-h CT (aOR 0.46; 95% CI 0.23-0.95; p = 0.04), lower collateral score (aOR 42.98; 95% CI 6.15-30.62; p < 0.001), and higher 24-h NIHSS score (aOR 1.34; 95% CI 1.24-1.44; p < 0.001).
CONCLUSION: Even with early and complete recanalization, elderly patients and those with poor collateral circulation remain at risk for futile recanalization. Identifying these predictors can guide patient selection, procedural planning, and post-procedural management to optimize functional outcomes.