Related Experiment Video
Updated: Sep 8, 2026
Focal Cerebral Ischemia Model by Endovascular Suture Occlusion of the Middle Cerebral Artery in the Rat
Published on: February 5, 2011
Unequal Efficacy of Different Infarct Location in Predicting Futile Recanalization of Patients With Acute Ischemic
Zhao-Shuo Li1, Hai-Long Zhong1, Teng-Fei Zhou1
1Department of Cerebrovascular Disease, Zhengzhou University People's Hospital, Zhengzhou, China.
Insights
Futile recanalization in acute ischemic stroke (AIS) is influenced by infarct location. Specific regions in the left (internal capsule, M3) and right (M6) hemispheres predict poor outcomes after endovascular thrombectomy (EVT) for AIS.
Area of Science:
- Neurology
- Radiology
- Interventional Cardiology
Background:
- Endovascular thrombectomy (EVT) is a standard treatment for acute ischemic stroke (AIS) due to large vessel occlusion.
- Futile recanalization is a key factor impacting patient prognosis after EVT.
- Identifying predictors of futile recanalization is crucial for optimizing treatment decisions.
Purpose of the Study:
- To investigate the efficacy of different infarct locations, as defined by the Alberta Stroke Program Early CT Score (ASPECTS) subregions, in predicting futile recanalization in AIS patients undergoing EVT.
- To determine if infarct site patterns differ in their predictive value for futile recanalization between the left and right cerebral hemispheres.
Main Methods:
- Data from two multicenter, prospective, randomized, controlled trials in China were analyzed.
- Patients with successful recanalization and complete preoperative ASPECTS and 90-day follow-up data were included.
- Univariate and multivariate logistic regression models were used to assess the association between ASPECTS subregions and futile recanalization.
Main Results:
- A total of 336 AIS patients were included, with 189 (56.25%) experiencing futile recanalization.
- The predictive efficacy of ASPECTS subregions for poor outcomes varied between cerebral hemispheres.
- In the left hemisphere, infarcts in the internal capsule (OR: 1.42) and M3 (OR: 2.26) regions were significant predictors of futile recanalization.
- In the right hemisphere, infarcts in the M6 region (OR: 2.24) significantly predicted futile recanalization.
Conclusions:
- Infarct location significantly influences the prediction of futile recanalization in AIS patients treated with EVT.
- Preoperative identification of high-risk infarct patterns in the core or penumbra can inform EVT decision-making and improve patient outcomes.
Objectives:
Endovascular thrombectomy (EVT) is a standard treatment for acute ischemic stroke (AIS) caused by large vessel occlusion, while futile recanalization is the main factor influencing the prognosis. The present study aimed to investigate the efficacy of different infarct sites in predicting futile recanalization of patients with AIS.
Methods:
Data were obtained from two multicenter, prospective, randomized, and controlled trials, which were concurrently conducted in China. Cases achieving a successful recanalization and with complete data of preoperative Alberta Stroke Program Early CT score (ASPECTS) and 90-day follow-up were included. The ASPECTS subregions were used to mark different infarct locations in the two cerebral hemispheres. First, the distribution of each ASPECTS subregion in the left and right hemispheres and the whole brain was analyzed, respectively. Then, the regions associated with futile recanalization were initially assessed by a univariate model. Afterward, a multivariate logistic regression model was used to identify the efficacy of different infarct sites in predicting futile recanalization.
Results:
A total of 336 patients were included in this study with a median age of 65 years (IQR: 51-74), of whom 210 (62.50%) patients were male, and 189 (56.25%) met the definition of futile recanalization. The correlation between each ASPECTS subregion and poor outcome was different when it was restricted to a specific cerebral hemisphere. Moreover, in the left hemisphere, the internal capsule region (OR: 1.42, 95%CI: 1.13-1.95, P = 0.03) and the M3 region (OR: 2.26, 95%CI: 1.36-3.52, P = 0.001), and in the right hemisphere, M6 region (OR: 2.24, 95%CI: 1.32-3.36, P = 0.001) showed significantly higher efficacy in predicting futile recanalization.
Conclusion:
The efficacy of different infarct locations in predicting futile recanalization is different. Different preoperative patterns of the high-efficiency regions in the infarction core or penumbra can guide the thrombectomy decision-making.
