Failure of early neurological improvement can predict futile recanalization after successful interventional recanalization of anterior circulation tandem lesions

To explore whether the failure of early neurological improvement can predict futile recanalization after successful interventional recanalization of anterior circulation tandem lesions. A retrospective analysis was conducted on the clinical data of patients who received successful interventional rec...

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Veröffentlicht in:Clinical neurology and neurosurgery 2024-11, Vol.246, p.108596, Article 108596
Hauptverfasser: Zhang, Wensheng, Xing, Weifang, Li, Jie, Li, Yudi, He, Xiongjun, Liu, Yajie, He, Jinzhao, Ling, Li
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Sprache:eng
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Zusammenfassung:To explore whether the failure of early neurological improvement can predict futile recanalization after successful interventional recanalization of anterior circulation tandem lesions. A retrospective analysis was conducted on the clinical data of patients who received successful interventional recanalization treatment of anterior circulation tandem lesions from January 2019 to November 2023. The failure of early neurological improvement is defined as a decrease of less than 4 points in NIHSS score compared to preoperative score at 24 h after surgery. Statistical analysis was conducted using SPSS 26.0 software, and a forest plot and Receiver Operating Characteristic curve related to futile recanalization were drawn. A total of 120 patients received successful interventional recanalization of anterior circulation tandems lesion were included, including 68 cases of futile recanalization (56.67 %) and 52 cases of effective recanalization (43.33 %). The rate of failure of early neurological improvement in the futile recanalization group was higher than that in the effective recanalization group (94.12 % vs 34.62 %, P < 0.001). After adjusting for confounding factors, the rate of failure of early neurological improvement in the futile recanalization group was higher than that in the effective recanalization group (adjusted OR: 39.925; 95 % CI: 4.110–387.864; P = 0.001). The area under the Receiver Operating Characteristic curve using failure of neurological improvement for predicting futile recanalization was 0.800. Failure of early neurological improvement is an effective indicator for predicting futile recanalization after successful interventional recanalization in anterior circulation tandem lesions. •Failure of early neurological improvement (FENI) has been rarely studied in futile recanalization.•We explore the predictive value of FENI in patients with tandem lesions who received thrombectomy.•We find FENI is an effective indicator for predicting futile recanalization of tandem lesions.•FENI is associated with more complications after thrombectomy.•FENI could guide postoperative management after thrombectomy and reduce complications.
ISSN:0303-8467
1872-6968
1872-6968
DOI:10.1016/j.clineuro.2024.108596