Impact of intracranial artery calcification on mechanical thrombectomy outcomes and construction of a nomogram prediction model

LI Guangzong; ZHANG Yuesen; JU Hongming; YIN Lin

doi:10.3969/j.issn.1009-0126.2026.02.021

Abstract：Objective To investigate the impact of intracranial artery calcification on the prognosis of mechanical thrombectomy,identify independent risk factors for the prognosis of mechanical thrombectomy,and establish a nomogram model for predicting the prognosis.Methods A retrospective analysis was conducted on 194 elderly patients(aged≥60 years)with anterior circulation AIS who underwent mechanical thrombectomy in our department between January 2017 and December 2024.According to the 90-day mRS score,they were divided into a good prognosis group(56 cases)and a poor prognosis group(score:3-6,138 cases).Multivariate logistic regression analysis was applied to explore the risk factors for prognosis of mechanical thrombectomy.Then,a nomogram model for predicting postoperative prognosis was constructed,and the model was internally validated and evaluated.Results The good prognosis group exhibited significantly higher ASPECT score,and lower In(calcification volume on the lesion side+1)and In(overall calcification volume+1)than the poor prognosis group(P<0.01).Multivariate logistic regression analysis showed that ASPECT score(OR=1.506,95%CI:1.105-2.052,P=0.010)and total calcified volume(OR=0.729,95%CI:0.561-0.949,P=0.019)were independent risk factors for the prognosis of mechanical thrombectomy.The prediction curve of the nomogram model aligned closely with the calibration curve and approached the ideal reference line.Hosmer-Lemeshow goodness-of-fit test indicated its good fitness,and ROC curve analysis showed its AUC value of 0.762(95%CI:0.691-0.833),an accuracy of 0.737,a sensitivity of 0.625,and a specificity of 0.783.Conclusion ASPECT score and total calcified volume of intracranial arteries are independent risk factors for the prognosis of mechanical thrombectomy.