A new study from Ningbo No.2 Hospital in China has developed a model that may help predict which stroke patients are unlikely to benefit from endovascular thrombectomy (EVT), a procedure to remove large clots from the brain. The research focused on 390 patients who had acute ischemic stroke due to large vessel occlusion and who achieved successful reperfusion after EVT. Despite successful clot removal, some patients still had poor outcomes, a phenomenon known as futile reperfusion.
The model combined several factors measured before the procedure: the patient's NIHSS score (a measure of stroke severity), CT angiography and CT perfusion imaging (ASPECTS), time from stroke onset to reperfusion, collateral circulation scores, and blood markers such as C-reactive protein, glucose, white blood cell count, neutrophil count, and monocyte count. The model showed good ability to discriminate between patients who would have a good outcome and those who would not, with an area under the curve (AUC) of 0.795. At a specific threshold, the model was 82.2% specific and 76.1% accurate.
The study did not report any safety concerns or limitations, and it is important to note that this is a retrospective cohort study, which means it can only show associations, not cause and effect. The model needs to be validated in other patient groups before it can be used in clinical practice. For now, it offers a potential way to identify patients who might need additional treatments or closer monitoring after EVT.
