Deans' stroke musings: Clinical software for unsupervised automated net water uptake analysis predicts futile recanalization in acute ischemic 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.

Tuesday, September 8, 2026

Clinical software for unsupervised automated net water uptake analysis predicts futile recanalization in acute ischemic stroke

You are that BLITHERINGLY STUPID you don't know that predictions are useless? Survivors would like EXACT RECOVERY PROTOCOLS! GET THERE!

Clinical software for unsupervised automated net water uptake analysis predicts futile recanalization in acute ischemic stroke

Abdallah Aburub 1† *
O
Oussama Dob 1†
M
Mariana Gurschi 1
Y
Yashar Aghazadeh 1
J
Jumana Jaber 1
Z
Zaid Al-Tamimi 2
Z
Zaid Samhan 3
L
Lars Timmermann 4
A
André Kemmling 1,9‡

1. Department of Diagnostic and Interventional Neuroradiology, Philipps University of Marburg, Marburg, Germany
2. Clinic of Diagnostic and Interventional Radiology, Philipps University of Marburg, Marburg, Germany

Abstract

Objectives:

This study aimed to determine whether automated net water uptake (NWU) measured on admission non-contrast computed tomography (CT) independently predicts futile recanalization (FR) in anterior-circulation large vessel occlusion (LVO) stroke treated with endovascular thrombectomy (EVT).

Methods:

This was a retrospective single-center cohort study that included consecutive patients presenting at a tertiary care stroke center between January 2023 and April 2025. Patients were included if they presented with an anterior circulation LVO and had successful recanalization (mTICI 2b–3). An automated platform (VEOcore/MRAY) provided the Alberta Stroke Program Early CT Score (ASPECTS), perfusion metrics, and NWU. Associations with FR were analyzed using logistic regression. Discrimination was evaluated using receiver operating characteristic (ROC) analysis and Youden’s J statistic to identify an optimal NWU threshold, reporting the area under the curve (AUC), sensitivity, specificity, and predictive values.

Results:

Among 91 patients, 62 (68.1%) achieved recanalization with a 90-day modified Rankin Scale (mRS) score of 0–4, and 29 (31.9%) met the criteria for FR (mRS score 5–6). Those with FR were older (81.6 ± 8.3 vs. 76.9 ± 10.7 years; p = 0.044) and had more severe strokes at presentation (median National Institutes of Health Stroke Scale [NIHSS] score of 16 [13–20] vs. 9.5 [6–15]; p < 0.001). NWU in the core was higher in FR (21.9% [7.0–29.4]) than in non-FR cases (3.0% [0.5–7.3]; p < 0.001) and correlated with 90-day mRS (Pearson r = 0.602; 95% CI 0.452–0.719; p < 0.001). In multivariable models, NWU remained independently associated with FR (odds ratio [OR] 1.15; 95% CI 1.06–1.24; p < 0.001).

Conclusion:

Automated NWU on admission CT is an independent, strongly discriminative predictor of FR and 90-day disability. A tiered strategy using >11.5% as a risk flag and >17.5% as a high-specificity rule-in threshold may enhance early triage, prognostication, and clinical trial stratification. Prospective multicenter validation is warranted.