静脉通过时间延长对缺血性卒中患者血管内治疗后无效再通的预测价值OA

Objective To investigate the predictive value of prolonged venous transit(PVT)for fu-tile recanalization after endovascular treatment(EVT)in patients with ischaemic stroke.Methods We retrospectively enrolled 210 patients with acute anterior circulation large vessel occlusion ischaemic stroke who underwent EVT and achieved successful recanalization.Patients were divided into favourable recanalization group(modified Rankin Scale[mRS]score 0-2,n=103)and futile recanalization group(mRS score＞2-6,n=107)according to the 90-day mRS score.Clinical data,including general characteristics,laboratory findings,and CT perfusion parameters,were compared between the two groups.Multivariable logistic regression analysis was performed to identify independent pre-dictors of futile recanalization.Receiver operating characteristic(ROC)curves were constructed to evaluate the predictive value of PVT and the combined model for futile recanalization.Results The futile recanalization group had significantly higher age,the National Institutes of Health Stroke Scale(NIHSS)score,fasting plasma glucose(FPG),stress hyperglycaemia ratio(SHR),infarct core volume,hypoperfusion volume,number of thrombectomy passes,proportion of PVT positivity,and proportion of haemorrhagic transformation(HT)than the favourable recanalization group,whereas the Alberta Stroke Program Early CT Score(ASPECTS)and mismatch ratio were significantly lower(P＜0.05).Multivariable logistic regression analysis showed that PVT,NIHSS score,SHR and HTwere independent predictors of futile recanalization after EVT in patients with large vessel occlu-sion ischaemic stroke(P＜0.05).ROC curve analysis revealed that PVT alone predicted futile re-canalization with an area under the curve(AUC)of 0.728,whereas the combined model incorpora-ting PVT,NIHSS score,SHR,and HT achieved better predictive performance(AUC=0.882).Conclusion PVT may serve as an important imaging biomarker for predicting futile recanalization after EVT in patients with ischaemic stroke.The combined model of PVT,NIHSS score,SHR,and HT improves the predictive efficacy for futile recanalization.