ORIGINAL RESEARCH article
Front. Neurol.
Sec. Endovascular and Interventional Neurology
Risk Factors and Nomogram Prediction Model for Isolated Distal Deep Vein Thrombosis After Endovascular Treatment in Acute Ischemic Stroke Patients
Chao Wei 1
Xiang Li 1
Yueshi Huang 1
Renshuai Liu 1
Yu Yao 1
Jinghui Lin 2
Jianhong Yang 1
1. Centre of Cerebrovascular Diseases,, The First Affiliated Hospital of Ningbo University, Ningbo, China
2. Department of Neurosurgery, The First Affiliated Hospital of Ningbo University, Ningbo, China
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Abstract
Objective: To identify independent risk factors for isolated distal deep vein thrombosis (IDDVT) following endovascular treatment (EVT) in patients with acute ischemic stroke (AIS), and to establish a practical and accurate nomogram-based prediction model. Methods: A retrospective review was performed on 263 AIS patients who underwent EVT at the First Affiliated Hospital of Ningbo University between September 2022 and September 2024. Patients were divided into IDDVT and non-IDDVT groups based on postoperative ultrasound findings. Baseline characteristics were compared, and univariate and multivariate logistic regression analyses were conducted to determine independent predictors of IDDVT. A nomogram was constructed based on regression results. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis (DCA). Results: Among 263 patients, 45 (17.1%) developed IDDVT. Multivariate logistic regression revealed that elevated D-dimer levels, decreased lower limb muscle strength, prior stroke history, and intracranial hemorrhagic transformation after EVT were independent risk factors (all P < 0.05). The nomogram incorporating these predictors demonstrated excellent discrimination, with an AUC of 0.903 (95% CI: 0.856–0.950), sensitivity of 86.7%, and specificity of 87.2%. Calibration and DCA confirmed good accuracy and clinical applicability. Conclusion: Elevated D-dimer levels, reduced lower limb strength, history of stroke, and postoperative hemorrhagic transformation serve as critical warning indicators for IDDVT after EVT in AIS patients. The nomogram developed in this study provides a high-precision tool for individualized risk prediction, supporting early risk stratification and preventive decision-making in clinical practice.
Summary
Keywords
Acute ischemic stroke, endovascular treatment, Isolated distal deep vein thrombosis, nomogram, predictive model
Received
08 September 2025
Accepted
31 January 2026
Copyright
© 2026 Wei, Li, Huang, Liu, Yao, Lin and Yang. 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: Chao Wei
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