{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T10:54:57Z","timestamp":1791802497311,"version":"4.3.4"},"reference-count":24,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Interv Neuroradiol"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recent randomized trials have shown that patients presenting with large core infarctions benefit from endovascular thrombectomy compared to medical management. We report real-world outcomes and factors associated with futile recanalization in patients meeting large core criteria for SELECT2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective review of health system records from 1\/1\/2024 to 12\/31\/2024 for patients presenting with computed tomography (CT) Alberta Stroke Program Early CT Score (ASPECTS) 3\u20135 or CT perfusion (CTP) core infarction \u226550\u2005milliliters. Primary and secondary outcomes, 90-day modified Rankin Scale (mRS) score 0\u20132 and 0\u20133, respectively, were compared to rates reported in SELECT2. Logistic regression was used to identify factors independently associated with 90-day mRS 5\u20136 despite successful reperfusion (modified treatment in cerebral ischemia 2b-3).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 59 patients with 90-day outcome data, median CT ASPECTS and CTP core were 7 (5\u201310) and 78.5 (57\u2013119)\u2005mL, respectively. Twelve (20.3%) achieved mRS 0\u20132, while 18 (30.5%) were ambulatory (mRS 0\u20133). Recanalization was achieved in 51 subjects, of whom 27 (52.9%) had a devastating neurological outcome (mRS 5\u20136). Atrial fibrillation was the only factor independently associated with futile recanalization (odds ratio 13.5, 95% confidence interval 1.4\u2013128.8,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our real-world cohort of large core thrombectomy patients from daily clinical practice had identical rates of independent neurological function and lower ambulatory rates at 90 days to that reported in the treatment arm of SELECT2. A history of atrial fibrillation, independent of age and presenting stroke severity, was associated with futile recanalization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15910199251362088","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T07:17:51Z","timestamp":1753255071000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Real-world functional outcomes and predictors of futile recanalization in patients meeting criteria for SELECT2"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2111-5523","authenticated-orcid":false,"given":"Rahul R","family":"Karamchandani","sequence":"first","affiliation":[{"name":"Department of Neurology, Neurosciences Institute, Wake Forest University School of Medicine, Atrium Health, Charlotte, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Wang","sequence":"additional","affiliation":[{"name":"Clinical Quality Analytics, Atrium Health, Charlotte, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongmei","family":"Yang","sequence":"additional","affiliation":[{"name":"Clinical Quality Analytics, Atrium Health, Charlotte, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dale","family":"Strong","sequence":"additional","affiliation":[{"name":"Clinical Quality Analytics, Atrium Health, Charlotte, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy B","family":"Rhoten","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurosciences Institute, Atrium Health, Charlotte, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan D","family":"Clemente","sequence":"additional","affiliation":[{"name":"Charlotte Radiology, Neurosciences Institute, Atrium Health, Charlotte, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Defilipp","sequence":"additional","affiliation":[{"name":"Charlotte Radiology, Neurosciences Institute, Atrium Health, Charlotte, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil M","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Pulmonary and Critical Care, Neurosciences Institute, Atrium Health, Charlotte, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe D","family":"Bernard","sequence":"additional","affiliation":[{"name":"Carolina Neurosurgery and Spine Associates, Neurosciences Institute, Atrium Health, Charlotte, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William R","family":"Stetler","sequence":"additional","affiliation":[{"name":"Carolina Neurosurgery and Spine Associates, Neurosciences Institute, Atrium Health, Charlotte, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9634-6406","authenticated-orcid":false,"given":"Jonathan M","family":"Parish","sequence":"additional","affiliation":[{"name":"Carolina Neurosurgery and Spine Associates, Neurosciences Institute, Atrium Health, Charlotte, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew U","family":"Hines","sequence":"additional","affiliation":[{"name":"Charlotte Radiology, Neurosciences Institute, Atrium Health, Charlotte, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shraddha T","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurosciences Institute, Wake Forest University School of Medicine, Atrium Health, Charlotte, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasser","family":"Saba","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurosciences Institute, Wake Forest University School of Medicine, Atrium Health, Charlotte, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamour","family":"Tareen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurosciences Institute, Wake Forest University School of Medicine, Atrium Health, Charlotte, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harsh N","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurosciences Institute, Wake Forest University School of Medicine, Atrium Health, Charlotte, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satheesh K","family":"Bokka","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurosciences Institute, Wake Forest University School of Medicine, Atrium Health, Charlotte, NC, 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