Do you not understand, prediction is useless for stroke survivors? It does nothing to get them recovered. There are a lot of mentors and senior researchers that need to be re-educated on the purpose of stroke research. The only goal in stroke is 100% recovery; not biomarkers, prediction, prognosis or other useless shit!
Why are you stenting at all? Verify that the Circle of Willis is complete, close up the offending artery and you won't have to deal with all these complications!
My right carotid artery was closed for 10 years and I cognitively functioned quite well with no episodes of fainting.
Here is why your doctor needs to guarantee NO complications from stenting!
stenting (22 posts to May 2011)
carotid stenting (21 posts to May 2016)
carotid artery stenting (7 posts to November 2021)
A nomogram, also called a nomograph, alignment chart, or abac, is a graphical calculating device, a two-dimensional diagram designed to allow the approximate graphical computation of a mathematical function.
Development and validation of a nomogram for cerebral hemorrhage in patients with carotid stenosis undergoing stenting: a multicenter retrospective study
Abstract
Background Hyperperfusion-induced cerebral hemorrhage (HICH) is a rare but severe complication in patients with carotid stenosis undergoing stent placement for which predictive models are lacking. Our objective was to develop a nomogram to predict such risk.
Methods We included a total of 1226 patients with carotid stenosis who underwent stenting between June 2015 and December 2022 from three medical centers, divided into a development cohort of 883 patients and a validation cohort of 343 patients. The model used LASSO regression for feature optimization and multivariable logistic regression to develop the predictive model. Model accuracy was assessed via the receiver operating characteristic curve, with further evaluation of calibration and clinical utility through calibration curves and decision curve analysis (DCA). The model underwent internal validation using bootstrapping and external validation with the validation cohort.
Results Older age (OR 1.07, p=0.005), higher degrees of carotid stenosis (OR 1.07, p=0.006), poor collateral circulation (OR 6.26, p<0.001), elevated preoperative triglyceride levels (OR 1.27, p=0.041) and neutrophil counts (OR 1.36, p<0.001) were identified as independent risk factors for HICH during hospitalization. The nomogram constructed based on these predictive factors demonstrated an area under the curve (AUC) of 0.817. The AUCs for internal and external validation were 0.809 and 0.783, respectively. Calibration curves indicated good model fit, and DCA confirmed substantial clinical net benefit in both cohorts.
Conclusion We developed and validated a nomogram to predict(NOT PREVENT!) HICH in patients with carotid stenosis post-stenting, facilitating early identification and preventive intervention in high-risk individuals.
Data availability statement
Data are available upon reasonable request. The data supporting the conclusions of this study are available from the corresponding author upon reasonable request at wangnaidong163@163.com.
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