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Association of Interleukin-6 Levels and Futile Reperfusion After Mechanical Thrombectomy
Laura Mechtouff1, Thomas Bochaton2, Alexandre Paccalet2
1From the Stroke Center (L.M., L.D., E.O., T.-H.C., N.N.), Cardiac Intensive Care Unit (T.B.), Clinical Investigation Center (M.B., C.A., N.M., M.O.), INSERM 1407, Neuroradiology Department (Y.B., O.F.E.), and NeuroBioTec (N.D.), CRB, Hospices Civils de Lyon; and INSERM U1060 (L.M., T.B., A.P., C.C.D.S., E.O., M.O., T.-H.C., N.N.), CarMeN Laboratory, and CREATIS (Y.B.), CNRS UMR 5220, INSERM U1044, University Lyon 1, France. laura.mechtouff@chu-lyon.fr.
Objective:
To assess whether interleukin-6 (IL-6) level is a marker of futile reperfusion in patients with acute ischemic stroke (AIS) with large vessel occlusion treated with mechanical thrombectomy (MT).
Methods:
The Cohort of Patients to Identify Biological and Imaging Markers of Cardiovascular Outcomes in Stroke (HIBISCUS-STROKE) includes patients with AIS treated with MT after MRI. We performed a sequential assessment of IL-6 (admission, 6 hours, 24 hours, 48 hours and 3 months from admission). Among patients with successful reperfusion (Thrombolysis in Cerebral Infarction scale 2b/3), reperfusion was considered effective if 3-month modified Rankin Scale (mRS) score was 0 to 2 and futile if 3-month mRS score was 3 to 6. Our model was adjusted for the main confounding variables.
Results:
One hundred sixty-four patients represent the study population. One hundred thirty-three patients had successful reperfusion (81.1%), while in 46 (34.6%), reperfusion was classified as futile. In single-variable analyses, high IL-6 levels at 6, 24, and 48 hours in combination with a higher age, a prestroke mRS score >2, a history of hypertension or diabetes, lack of current smoking, a higher baseline NIH Stroke Scale score, the absence of associated intravenous thrombolysis, an intracranial internal carotid artery or a tandem occlusion, and an increased infarct growth were associated with futile reperfusion. After multivariable analyses, a high IL-6 level at 24 hours (odds ratio 6.15, 95% confidence interval 1.71-22.10) remained associated with futile reperfusion.
Conclusions:
IL-6 is a marker of futile reperfusion in the setting of MT.
