{
  "abstract": "Background Despite successful reperfusion after endovascular therapy (EVT), over 50% of patients with large vessel occlusion (LVO) and large core infarction fail to achieve favorable functional outcomes, termed ‘futile recanalization’. This study aimed to identify predictors and develop a scoring system to predict futile recanalization in patients with LVO and large core infarction undergoing EVT.Methods Patients were selected from the Acute Anterior Circulation Large Vessel Occlusive Patients With a Large Infarct Core (ANGEL-ASPECT) trial. Futile recanalization was defined as a modified Rankin Scale (mRS) score of >3 at 90 days despite successful reperfusion (extended Thrombolysis in Cerebral Infarction scale ≥2b). Participants were divided into futile (mRS >3) and no-futile (mRS ≤3) recanalization groups. Multivariable logistic regression was used to develop the predictive scale, with model performance assessed via a receiver operating characteristic (ROC) curve and Hosmer–Lemeshow test.Results Of 146 patients, 74 had futile recanalization. A six-item scale (0–6 points) was developed, including gender, age, systolic blood pressure, admission National Institutes of Health Stroke Scale score, blood glucose, and neutrophil-to-lymphocyte ratio. The scale showed good predictive performance (area under the ROC curve (AUC) 0.806, 95% CI 0.737 to 0.876) and good calibration (Hosmer–Lemeshow test, P=0.837). The optimal cut-off value of the scale was ≥3 points with 81% sensitivity, 70% specificity, and 76% accuracy.Conclusions The pre-EVT scale could effectively predict 90-day futile recanalization before EVT, providing a valuable tool for clinical decision-making and risk stratification in patients with LVO and large core infarction.",
  "authors": [
    {
      "affiliations": [
        "Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China",
        "China National Clinical Research Center for Neurological Diseases, Beijing, China"
      ],
      "name": "Yawen Gan"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China",
        "China National Clinical Research Center for Neurological Diseases, Beijing, China"
      ],
      "name": "Jie He"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China",
        "China National Clinical Research Center for Neurological Diseases, Beijing, China"
      ],
      "name": "Zhongao Guan"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China",
        "China National Clinical Research Center for Neurological Diseases, Beijing, China"
      ],
      "name": "Ketao Tu"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China",
        "China National Clinical Research Center for Neurological Diseases, Beijing, China"
      ],
      "name": "Fangguang Chen"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China",
        "China National Clinical Research Center for Neurological Diseases, Beijing, China",
        "Department of Neurology, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China"
      ],
      "name": "Shuang Song"
    },
    {
      "affiliations": [
        "China National Clinical Research Center for Neurological Diseases, Beijing, China"
      ],
      "name": "Dingwen Zhang"
    },
    {
      "affiliations": [
        "China National Clinical Research Center for Neurological Diseases, Beijing, China",
        "Department of Neurology, Beijing Tiantan Hospital, Captical Medical University, Beijing, China"
      ],
      "name": "Yuesong Pan"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China",
        "China National Clinical Research Center for Neurological Diseases, Beijing, China"
      ],
      "name": "Zhongrong Miao"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China",
        "China National Clinical Research Center for Neurological Diseases, Beijing, China"
      ],
      "name": "Dapeng Mo"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China",
        "China National Clinical Research Center for Neurological Diseases, Beijing, China"
      ],
      "name": "Xu Tong"
    }
  ],
  "title": "A pre-intervention six-item scale for predicting futile recanalization after endovascular therapy in patients with acute ischemic stroke with large core infarction",
  "uid": "0e5fa192-09a0-50b8-98c9-d23a7b7eb931"
}