Age‐Specific Differences in Inflammatory Biomarkers and Their Impact on Futile Recanalization After Mechanical Thrombectomy: An Inverse Probability Weighting Analysis DOI Creative Commons
Gabriele Prandin, Mariarosaria Valente, Liqun Zhang

и другие.

European Journal of Neurology, Год журнала: 2025, Номер 32(5)

Опубликована: Май 1, 2025

ABSTRACT Background Mechanical thrombectomy (MT) is the standard treatment for large vessel occlusion (LVO) stroke. However, a substantial proportion of patients experience poor functional outcomes despite successful reperfusion, namely futile recanalization (FR). This study aimed to evaluate predictive value inflammatory biomarkers, measured on admission and at 24 h, in identifying risk FR assess age‐specific differences influencing this outcome. Methods international, multicenter, observational included with anterior circulation LVO stroke treated MT. Strict inclusion criteria were applied minimize confounding factors related inflammation. Inflammatory biomarkers assessed h post‐procedure. Inverse probability weighting (IPW) was utilized balance baseline characteristics between effective (ER). Least absolute shrinkage selection operator (LASSO) regression identify independent predictors, restricted cubic splines used determine optimal biomarker cut‐offs. Results Among 885 patients, 470 (53%) experienced FR. In multivariate analysis, 24‐h CRP (OR 1.01, 95% CI 1.01–1.02, p = 0.018) NLR 1.11, 1.02–1.22, 0.019) significant predictors FR, cut‐offs 8.55 4.58, respectively. aged < 80 years, most (cut‐offs: 17.09 5.59). ≥ SIRI emerged as predictor 1.24, 1.06–1.50, 0.015), an cut‐off 2.53. Conclusions exhibit following MT, distinct patterns. These findings underscore importance tailoring models interventions optimize clinical outcomes.

Язык: Английский

Post-procedural Plasma D-dimer Level May Predict Futile Recanalization in Stroke Patients with Endovascular Treatment DOI Creative Commons
Min Zhao, Zhengze Dai, Rui Liu

и другие.

Journal of Stroke and Cerebrovascular Diseases, Год журнала: 2025, Номер unknown, С. 108248 - 108248

Опубликована: Янв. 1, 2025

High D-dimer levels may increase the likelihood of unfavorable clinical outcomes in patients with acute ischemic stroke. However, impacts serum on reperfusion treatment stroke have not been evaluated. This study aims to assess a possible relationship between and functional endovascular (EVT). Patients who underwent successful EVT were enrolled. Plasma was measured before within 6 hours after procedures. Futile recanalization defined as modified Rankin Scale score 3-6 at 90 days onset. Multivariable logistic regression analyses performed determine relationships futile recanalization. Of 161 enrolled patients, 78 (48.4%) classified After adjusting for potential confounders, high post-procedural level associated (odds ratio, 1.25; 95% CI, 1.05-1.51; P =0.016). In recanalization, change increased significantly (P <0.001). Furthermore, 1.33; 1.11-1.65; =0.005) independently. plasma significant predict

Язык: Английский

Процитировано

0
Cerebral Edema Progression and Outcomes in Large Infarct Patients Undergoing Endovascular Thrombectomy DOI Open Access
Ximing Nie, Jinjie Liu, Bernard Yan

и другие.

Annals of Neurology, Год журнала: 2025, Номер unknown

Опубликована: Март 11, 2025

Objective The goal was to analyze the progression of cerebral edema post‐endovascular thrombectomy (EVT) in large infarcts and its association with functional outcomes. Methods A secondary analysis Endovascular Therapy Acute Anterior Circulation Large Vessel Occlusive Patients a Infarct Core trial conducted patients ischemic cores randomized receive either EVT or medical management (MM) alone. who had follow‐up imaging within 7 days post‐randomization were involved. primary outcome midline shift (MLS). Mediation performed as independent variable, MLS mediator, modified Rankin scale scores at 90 served endpoint. An exploratory on net water uptake (ΔNWU). Results Of 434 patients, median age 66.0 years (standard deviation [SD], 9.9), 61.3% (266) being males. associated an early increase 24 (±12) hours after randomization (mean 3.0 [4.2] vs 2.4 [3.6]mm; p = 0.03) compared MM group, partially mediating poorer outcomes post‐EVT (mediation proportion, −25%; 95% CI, −46.54 −4.10), but did not negate overall efficacy thrombectomy. NWU remained slower throughout days, inconsistent MLS. Interpretation In infarct cores, increased mass effect MM, potentially Despite evident benefits from thrombectomy, accurate prediction effective anti‐edema interventions for may further improve complex relationship between warrants investigation. ANN NEUROL 2025

Язык: Английский

Процитировано

0
Age‐Specific Differences in Inflammatory Biomarkers and Their Impact on Futile Recanalization After Mechanical Thrombectomy: An Inverse Probability Weighting Analysis DOI Creative Commons
Gabriele Prandin, Mariarosaria Valente, Liqun Zhang

и другие.

European Journal of Neurology, Год журнала: 2025, Номер 32(5)

Опубликована: Май 1, 2025

ABSTRACT Background Mechanical thrombectomy (MT) is the standard treatment for large vessel occlusion (LVO) stroke. However, a substantial proportion of patients experience poor functional outcomes despite successful reperfusion, namely futile recanalization (FR). This study aimed to evaluate predictive value inflammatory biomarkers, measured on admission and at 24 h, in identifying risk FR assess age‐specific differences influencing this outcome. Methods international, multicenter, observational included with anterior circulation LVO stroke treated MT. Strict inclusion criteria were applied minimize confounding factors related inflammation. Inflammatory biomarkers assessed h post‐procedure. Inverse probability weighting (IPW) was utilized balance baseline characteristics between effective (ER). Least absolute shrinkage selection operator (LASSO) regression identify independent predictors, restricted cubic splines used determine optimal biomarker cut‐offs. Results Among 885 patients, 470 (53%) experienced FR. In multivariate analysis, 24‐h CRP (OR 1.01, 95% CI 1.01–1.02, p = 0.018) NLR 1.11, 1.02–1.22, 0.019) significant predictors FR, cut‐offs 8.55 4.58, respectively. aged < 80 years, most (cut‐offs: 17.09 5.59). ≥ SIRI emerged as predictor 1.24, 1.06–1.50, 0.015), an cut‐off 2.53. Conclusions exhibit following MT, distinct patterns. These findings underscore importance tailoring models interventions optimize clinical outcomes.

Язык: Английский

Процитировано

0