Intracranial and Peripheral Inflammatory Biomarkers Predict Futile Recanalization After Endovascular Treatment

Area of Science:

• Neuroscience
• Immunology
• Vascular Biology

Background:

• Futile recanalization, defined as lack of functional independence post-endovascular treatment (EVT), is a significant challenge in large vessel occlusion stroke.
• Inflammation plays a crucial role in brain reperfusion injury, impacting stroke recovery.
• Investigating immune biomarkers associated with EVT outcomes is essential for improving patient care.

Purpose of the Study:

• To quantify immune and vascular biomarkers in intracranial and peripheral blood samples.
• To determine the association between these biomarkers and futile recanalization after successful EVT.
• To identify potential biomarkers for risk stratification in stroke patients.

Main Methods:

• Prospective single-center cohort study of patients with anterior circulation large vessel occlusion and successful EVT.
• Collection of intracranial and peripheral blood samples at various time points (pre-EVT, post-EVT, 24-hour post-EVT).
• Measurement of 37 immune-vascular biomarkers and statistical analysis to assess their association with futile recanalization (90-day mRS 3-6).

Main Results:

• 46% of patients experienced futile recanalization.
• Six biomarkers (IL-6, IL-10, IL-15, VEGFR1, VCAM-1, SAA) showed significant associations with futile recanalization.
• Adjusted analyses identified VCAM-1, IL-10, IL-15, and SAA as predictors of futile recanalization.

Conclusions:

• A specific set of immune-vascular mediators in blood predicts futile recanalization after EVT.
• These findings support the use of biomarkers for risk stratification in stroke patients.
• Targeting microvascular inflammation could be a promising therapeutic strategy.