ORIGINAL RESEARCH article
Front. Neurol.
Sec. Endovascular and Interventional Neurology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1630438
Predictors of Futile Recanalization After Endovascular Therapy in Anterior Circulation Stroke with Large Core Infarction
Provisionally accepted
Qinhong Li1,2Chawen Ding3,4Boyu Chen3,5Zhenxuan Tian3
Yujie Chen6Linyu Li3Nizhen Yu7
Jiaxing Song3Jie Yang7Changwei Guo8
Jiacheng Huang3
Wenjie Zi3,7
yang zhao1,2*- 1chongqing medical university, chongqing, China
- 2Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
- 3The Second Affiliated Hospital, chongqing medical university, chongqing, China
- 4ChongGang General Hospital, chongqing, China
- 5Qujing First People's Hospital, yunnan, China
- 6Xinan Hospital and The First Affiliated Hospital,, chongqing, China
- 7Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), chongqing, China
- 8xinqiao hosipital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), chongqing, China
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Background: There is a lack of data to predict futile recanalization (FR) after endovascular treatment (EVT) in acute anterior circulation large vessel occlusion (ACLVO) with large core infarction. Methods: This analysis included patients from a national multicenter stroke registry (November 2021 to February 2023). Patients who achieved successful recanalization (expanded Thrombolysis in Cerebral Infarction [eTICI] score ≥2b) after EVT were categorized into two groups: meaningful recanalization (MR; 90-day modified Rankin Scale [mRS] 0-3) and FR (mRS 4-6). Multivariate logistic regression was performed to identify independent predictors of FR. Results: Among 313 patients with successful recanalization, 171 (54.6%) experienced FR, and 142 (45.4%) achieved MR. Multivariate analysis showed that a higher baseline NIH Stroke Scale score (P<.001), older age (P<.001), elevated blood glucose (P=.003), poor collateral circulation (P=.004), and incomplete recanalization (eTICI 2b vs. 3; P<.001) were predictors of FR.Conclusions: In patients with ACLVO and large core infarction, age, hyperglycemia, baseline NIHSS, poor collaterals, and incomplete recanalization were independent predictors of FR. These findings may be used to guide treatment decisions and optimize management processes.
Keywords: Anterior circulation large vessel occlusion, large core ischemic stroke, endovascular treatment, futile recanalization, Modified Rankin scale
Received: 17 May 2025; Accepted: 05 Aug 2025.
Copyright: © 2025 Li, Ding, Chen, Tian, Chen, Li, Yu, Song, Yang, Guo, Huang, Zi and zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: yang zhao, Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
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