{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:54:37Z","timestamp":1790747677826,"version":"4.1.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Endovascular therapy (EVT) is effective for acute anterior circulation large vessel occlusion (LVO), yet futile recanalization remains common. Identifying its predictors is essential to optimize patient selection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study included 311 patients with anterior circulation LVO who underwent successful EVT. Patients were divided into an effective recanalization group (90-day modified Rankin Scale (mRS) score \u2264 2,\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f150) and a futile recanalization group (mRS\u202f&amp;gt;\u202f2,\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f161). Clinical, imaging, and procedural variables were compared. Multivariate logistic regression was used to identify independent predictors, and a predictive model was evaluated using receiver operating characteristic (ROC) curve analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline comparisons between the two groups showed significant differences in age, sex, atrial fibrillation, stress hyperglycemia ratio (SHR), C-reactive protein, admission National Institutes of Health Stroke Scale (NIHSS) score, diffusion-weighted imaging (DWI) infarct volume, DWI-Alberta Stroke Program Early CT Score (DWI-ASPECTS) score, number of procedure attempts, and procedure time. Univariate logistic regression and multivariate logistic regression identified admission NIHSS score (OR\u202f=\u202f1.381, 95% CI: 1.113\u20131.713,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.003), DWI infarct volume (OR\u202f=\u202f1.057, 95% CI: 1.025\u20131.090,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), DWI-ASPECT score (OR\u202f=\u202f69.240, 95% CI: 9.819\u2013488.254,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), procedure time (OR\u202f=\u202f1.011, 95% CI: 1.005\u20131.018,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), and SHR (OR\u202f=\u202f3.447, 95% CI: 1.302\u20139.129,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.013) as independent predictors of futile recanalization. A combined model incorporating these five predictors achieved an area under the curve (AUC) of 0.815 (sensitivity: 0.789, specificity: 0.787, Youden index: 0.576).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Admission NIHSS score, SHR, DWI infarct volume, DWI-ASPECT score, and procedure time are independent predictors of futile recanalization after EVT for anterior circulation LVO stroke. Higher NIHSS score, elevated SHR, larger infarct volume, lower DWI-ASPECT score, and prolonged procedure time increase the risk of poor functional outcome despite successful reperfusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1777164","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:56:08Z","timestamp":1790744168000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of futile recanalization following endovascular therapy for acute anterior circulation large vessel occlusion stroke: a retrospective cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Yangchun","family":"Wen","sequence":"first","affiliation":[{"name":"Department of Neurology, Heyuan Hospital of Traditional Chinese Medicine","place":["Heyuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Heyuan Hospital of Traditional Chinese Medicine","place":["Heyuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiujing","family":"Liao","sequence":"additional","affiliation":[{"name":"Heyuan People\u2019s Hospital","place":["Heyuan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanghong","family":"Zhong","sequence":"additional","affiliation":[{"name":"Heyuan People\u2019s Hospital","place":["Heyuan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongli","family":"Gu","sequence":"additional","affiliation":[{"name":"Heyuan People\u2019s Hospital","place":["Heyuan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Zhang","sequence":"additional","affiliation":[{"name":"Heyuan People\u2019s Hospital","place":["Heyuan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Xie","sequence":"additional","affiliation":[{"name":"Heyuan People\u2019s Hospital","place":["Heyuan, Guangdong, China"]},{"name":"Heyuan Key Laboratory of Molecular Diagnosis and Disease Prevention and Treatment, Doctors Station of Guangdong Province, Heyuan People's Hospital","place":["Heyuan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"651","DOI":"10.3389\/fneur.2017.00651","article-title":"Ischemic strokes due to large-vessel occlusions contribute disproportionately to stroke-related dependence and death: a review","volume":"8","author":"Malhotra","year":"2017","journal-title":"Front 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mechanical Thrombectomy: insights from the ASTER trial (contact aspiration versus stent retriever for successful revascularization)","volume":"49","author":"Dargazanli","year":"2018","journal-title":"Stroke"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1159\/000539269","article-title":"Sex differences in outcomes after endovascular Thrombectomy for patients with acute ischemic stroke","volume":"87","author":"Chen","year":"2024","journal-title":"Eur Neurol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"e71245","DOI":"10.1002\/brb3.71245","article-title":"Association of the Stress Hyperglycemia Ratio and Prognosis after Endovascular Treatment: a systematic review and Meta-analysis","volume":"16","author":"You","year":"2026","journal-title":"Brain Behav"}],"container-title":["Frontiers in 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