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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Nomogram to predict unfavorable outcome of endovascular thrombectomy for large ischemic core

Nannan Han1, Xiaobo Zhang2, Yu Zhang2

  • 1Department of Neurology, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, China.

Annals of Clinical and Translational Neurology
|June 17, 2023
PubMed

Insights

A new nomogram predicts poor outcomes for stroke patients with large ischemic cores after endovascular thrombectomy. This tool uses clinical and imaging data to assess risk, aiding treatment decisions.

Area of Science:

  • Neurology
  • Radiology
  • Interventional Cardiology

Background:

  • Patients with large ischemic cores (LIC) after endovascular thrombectomy have a poor prognosis.
  • Accurate prediction of outcomes is crucial for guiding treatment strategies.

Purpose of the Study:

  • To develop and validate a predictive nomogram for 3-month unfavorable outcomes in patients with anterior circulation occlusion-related LIC undergoing endovascular thrombectomy.

Main Methods:

  • A retrospective training cohort and a prospective validation cohort were analyzed.
  • Clinical and diffusion-weighted imaging radiomic features were collected.
  • A nomogram was constructed using selected features to predict modified Rankin Scale scores (3-6) as unfavorable outcomes.

Main Results:

  • The study included 140 patients (95 training, 45 validation).
  • Age, National Institute of Health Stroke Scale (NIHSS) score, Maximum2DDiameterColumn, and Maximum2DDiameterSlice were significant predictors.
  • The nomogram showed strong discriminatory power with an AUC of 0.892 (training) and 0.872 (validation).

Conclusions:

  • The developed nomogram effectively predicts unfavorable outcomes in patients with LIC from anterior circulation occlusion.
  • This tool can aid clinicians in risk stratification and treatment planning for these complex stroke cases.
Abstract

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