Deans' stroke musings: Predictors of futile recanalization after endovascular therapy in anterior circulation stroke with large core infarction

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, August 25, 2025

Predictors of futile recanalization after endovascular therapy in anterior circulation stroke with large core infarction

More useless crapola, predicting a problem; NOT SOLVING THE PROBLEM! You're fired!

Predictors of futile recanalization after endovascular therapy in anterior circulation stroke with large core infarction

Qinhong Li¹^†

Chawen Ding^2,3^†

Boyu Chen^2,4^†

Zhenxuan Tian^2,5

Yujie Chen⁶

Linyu Li²

Nizhen Yu⁷

Jiaxing Song²

Jie Yang⁷

Changwei Guo⁷

Jiacheng Huang²

Wenjie Zi^2,7^*

Zhao Yang¹^*

¹Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
²Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
³Department of Neurology, ChongGang General Hospital, Chongqing, China
⁴Department of Neurology, Qujing First People's Hospital, Qujing, China
⁵Department of Neurology, Sichuan Mianyang 404 Hospital, Mianyang, China
⁶Department of Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
⁷Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China

Background: There is a lack of data to predict futile recanalization (FR) after endovascular treatment (EVT) in acute anterior circulation large vessel occlusion (ACLVO) with large core infarction.

Methods: This analysis included patients from a national multicenter stroke registry (November 2021 to February 2023). Patients who achieved successful recanalization (expanded Thrombolysis in Cerebral Infarction [eTICI] score ≥2b) after EVT were categorized into two groups: meaningful recanalization (MR; 90-day modified Rankin scale [mRS] 0–3) and FR (mRS 4–6). Multivariate logistic regression was performed to identify independent predictors of FR.

Results: Among 313 patients with successful recanalization, 171 (54.6%) experienced FR, and 142 (45.4%) achieved MR. Multivariate analysis showed that a higher baseline NIH Stroke Scale score (p < 0.001), older age (p < 0.001), elevated blood glucose (p = 0.003), poor collateral circulation (p = 0.004), and incomplete recanalization (eTICI 2b vs. 3; p < 0.001) were predictors of FR.

Conclusion: In patients with ACLVO and large core infarction, age, hyperglycemia, baseline NIHSS, poor collaterals, and incomplete recanalization were independent predictors of FR. These findings may be used to guide treatment decisions and optimize management processes.