Construction of a prediction model for futile recanalization after thrombectomy of acute LVO in elderly patients with AF
Zhang Wenjun
Chen Kechun
Shi Huimin
Zhou Yin
Abstract：Objective To explore the risk factors for futile recanalization after mechanical throm-bectomy for acute large vessel occlusion(LVO)in elderly patients with atrial fibrillation(AF),and construct a prediction model.Methods A total of 146 elderly AF patients who undergoing mechanical thrombectomy due to LVO and achieved successful recanalization(modified thromb-olysis in cerebral infarction,mTICI≥2b)in our hospital from January 2018 to July 2023 were consecutively recruited in this retrospective analysis.According to the 90-day clinical outcome,they were divided into a futile recanalization group(79 cases)and an effective recanalization group(67 cases).The general clinical data were compared between the two groups.Multivariate logistic regression analysis was performed to identify the risk factors for futile recanalization,and based the factors,a nomogram for the prediction was drawn.ROC curve and calibration curve analyses were applied to evaluate the reliability of the prediction model,and decision curve analysis was conducted to assess the clinical application value.Results Multivariate logistic regression analysis identified that baseline blood glucose,NT-proBNP,internal carotid artery occlusion,and thrombec-tomy≥3 attempts were independent risk factors for futile recanalization(OR=1.395,95％CI:1.174-1.658,P=0.000;OR=1.001,95％CI:1.000-1.001,P=0.003;OR=8.024,95％CI:2.554-25.204,P=0.000;OR=5.056,95％CI:1.778-14.375,P=0.002).The AUC value of the prediction model was 0.868(95％CI:0.808-0.929).Calibration curve analysis showed that the model obtained consistent predicted probability with actual probability,and decision curve analy-sis indicated that the model had good clinical benefit.Conclusion Baseline blood glucose,NT-proBNP,internal carotid artery occlusion,and thrombectomy≥3 attempts are independent risk factors for futile recanalization after mechanical thrombectomy in elderly AF patients.Our prediction model has good predictive performance and prediction accuracy,but its application still needs prospective research and external verification.
Keywords：atrial fibrillationforecastingregression analysisrisk factors
Publication Date：2025-03-14
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 298-302 )