Multi-inflammatory index as a predictor of futile recanalization in acute ischemic stroke patients undergoing...

Area of Science:

• Neurology
• Biomarkers
• Inflammation

Background:

• Mechanical thrombectomy (MT) for acute ischemic stroke (AIS) can result in futile recanalization (FR), characterized by poor functional outcomes despite successful reperfusion.
• The multi-inflammatory index (MII) is a novel biomarker for systemic inflammation.
• This study investigates the predictive capability of MII-1, MII-2, and MII-3 for FR in AIS patients undergoing MT.

Purpose of the Study:

• To evaluate the predictive value of MII scores for futile recanalization in AIS patients treated with MT.
• To determine if MII can serve as a biomarker to identify patients at risk for poor outcomes post-MT.

Main Methods:

• Retrospective analysis of 277 AIS patients who underwent MT.
• Futile recanalization (FR) defined as modified Rankin Scale (mRS) score ≥4 at 90 days despite successful recanalization (mTICI ≥2b).
• Multivariable logistic regression and ROC analysis to assess the association between MIIs and FR.

Main Results:

• Among 205 patients with successful recanalization, 58 (28.3%) experienced FR.
• Patients with FR exhibited higher baseline NIHSS scores, more frequent hypertension and diabetes, elevated HbA1c, and significantly higher MII-1, MII-2, and MII-3 values.
• Multivariable analysis confirmed MIIs as independent predictors of FR, with moderate discriminative ability.

Conclusions:

• Elevated MII-1, MII-2, and MII-3 independently predict futile recanalization in AIS patients undergoing MT.
• MII may aid in refining patient selection and tailoring post-procedural management strategies for AIS patients.
• MII serves as a valuable biomarker for predicting outcomes in AIS patients post-MT.