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Updated: Oct 28, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Early Post-Operative Quantitative EEG Central Beta Power Predicts Futile Recanalization After Endovascular Treatment
Ji-Ru Cai1,2, Feng Xue2, Zi-Ai Zhao2
1College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China.
Background And Purpose:
Despite successful endovascular recanalization in acute ischemic stroke, approximately 50%-55% of patients experience 90-day futile recanalization (FR). We evaluated the prognostic value of central relative beta power derived from early postoperative quantitative electroencephalography (QEEG) and explored QEEG associations with brain edema and parenchymal hemorrhage.
Methods:
This retrospective, single-center subgroup analysis of the prospective multicenter DETECT2-China registry included 56 patients with acute ischemic stroke due to large-vessel occlusion. Patients underwent 20-30-min EEG recordings approximately 24 h after successful endovascular treatment. Multivariable logistic regression adjusting for seven clinical covariates, Firth and reduced-model sensitivity analyses, and leave-one-out cross-validation (LOOCV) with the DeLong test were performed. An additional sensitivity analysis repeated QEEG feature selection within each training set. Feature reliability was evaluated using split-half intraclass correlation coefficients (ICCs).
Results:
Of 56 patients, 31 (55.4%) developed 90-day FR. Higher central relative beta power was independently associated with lower odds of FR (adjusted OR: 0.28 per 1-SD increase, 95% CI: 0.11-0.74, p = 0.010). Integrating central beta power into the clinical model increased the fixed-feature LOOCV area under the receiver operating characteristic curve (AUC) from 0.557 to 0.719 (DeLong p = 0.007). In exploratory analyses, delta-band Brain Symmetry Index specifically tracked parenchymal hemorrhage (PH vs. no intracranial hemorrhage [No ICH], p = 0.006). Exploratory graph analysis also showed macro-scale network disintegration in FR patients. All QEEG features demonstrated high split-half reliability (ICC ≥ 0.75).
Conclusions:
Central relative beta power recorded approximately 24 h after endovascular treatment was independently associated with 90-day FR and showed potential incremental prognostic value. Exploratory associations with postoperative complications suggest that QEEG may provide a non-invasive bedside "brain window" for neurocritical care.