Deans' stroke musings: A visualized nomogram to online predict futile recanalization after endovascular thrombectomy in basilar artery occlusion stroke

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.

Wednesday, August 31, 2022

A visualized nomogram to online predict futile recanalization after endovascular thrombectomy in basilar artery occlusion stroke

What will you do with those patients you determine are futile? Leave them to rot? Figure out how to recover on their own with no help from medical 'professionals'?

A visualized nomogram to online predict futile recanalization after endovascular thrombectomy in basilar artery occlusion stroke

ShiTeng Lin^1,2^†,

XinPing Lin^1,2^†,

Juan Zhang³^†,

Meng Wan^2,4,

Chen Chen^2,4,

Qiong Jie^2,4,

YueZhang Wu^2,4,

RunZe Qiu^2,4,

XiaoLi Cui³,

ChunLian Jiang⁵^*,

JianJun Zou^2,4^* and

ZhiHong Zhao⁶^*

¹School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
²Department of Clinical Pharmacology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
³Department of Neurology, Nanjing Yuhua Hospital, Yuhua Branch of Nanjing First Hospital, Nanjing Medical University, Nanjing, China
⁴Department of Pharmacy, Nanjing First Hospital, China Pharmaceutical University, Nanjing, China
⁵Department of Pathology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
⁶Department of Neurology, The First Affiliated Hospital (People's Hospital of Hunan), Hunan Normal University, Changsha, China

Background and purpose: Futile recanalization occurs in a significant proportion of patients with basilar artery occlusion (BAO) after endovascular thrombectomy (EVT). Therefore, our goal was to develop a visualized nomogram model to early identify patients with BAO who would be at high risk of futile recanalization, more importantly, to aid neurologists in selecting the most appropriate candidates for EVT.

Methods: Patients with BAO with EVT and the Thrombolysis in Cerebral Infarction score of ≥2b were included in the National Advanced Stroke Center of Nanjing First Hospital (China) from October 2016 to June 2021. The exclusion criteria were lacking the 3-month Modified Rankin Scale (mRS), age <18 years, the premorbid mRS score >2, and unavailable baseline CT imaging. Potential predictors were selected for the construction of the nomogram model and the predictive and calibration capabilities of the model were assessed.

Results: A total of 84 patients with BAO were finally enrolled in this study, and patients with futile recanalization accounted for 50.0% (42). The area under the curve (AUC) of the nomogram model was 0.866 (95% CI, 0.786–0.946). The mean squared error, an indicator of the calibration ability of our prediction model, was 0.025. A web-based nomogram model for broader and easier access by clinicians is available online at https://trend.shinyapps.io/DynNomapp/.

Conclusion: We constructed a visualized nomogram model to accurately and online predict the risk of futile recanalization for patients with BAO, as well as assist in the selection of appropriate candidates for EVT.