Construction of a prediction model for futile recanalization after thrombectomy of acute LVO in elderly patients with AF
10.3969/j.issn.1009-0126.2025.03.010
- VernacularTitle:老年心房颤动患者急性大血管闭塞取栓术后发生无效再通的预测模型构建
- Author:
Wenjun ZHANG
1
;
Kechun CHEN
1
;
Huimin SHI
1
;
Yin ZHOU
1
Author Information
1. 215600 苏州大学附属张家港医院(张家港市第一人民医院)神经内科
- Publication Type:Journal Article
- Keywords:
atrial fibrillation;
forecasting;
regression analysis;
risk factors
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2025;27(3):298-302
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the risk factors for futile recanalization after mechanical throm-bectomy for acute large vessel occlusion(LVO)in elderly patients with atrial fibrillation(AF),and construct a prediction model.Methods A total of 146 elderly AF patients who undergoing mechanical thrombectomy due to LVO and achieved successful recanalization(modified thromb-olysis in cerebral infarction,mTICI≥2b)in our hospital from January 2018 to July 2023 were consecutively recruited in this retrospective analysis.According to the 90-day clinical outcome,they were divided into a futile recanalization group(79 cases)and an effective recanalization group(67 cases).The general clinical data were compared between the two groups.Multivariate logistic regression analysis was performed to identify the risk factors for futile recanalization,and based the factors,a nomogram for the prediction was drawn.ROC curve and calibration curve analyses were applied to evaluate the reliability of the prediction model,and decision curve analysis was conducted to assess the clinical application value.Results Multivariate logistic regression analysis identified that baseline blood glucose,NT-proBNP,internal carotid artery occlusion,and thrombec-tomy≥3 attempts were independent risk factors for futile recanalization(OR=1.395,95％CI:1.174-1.658,P=0.000;OR=1.001,95％CI:1.000-1.001,P=0.003;OR=8.024,95％CI:2.554-25.204,P=0.000;OR=5.056,95％CI:1.778-14.375,P=0.002).The AUC value of the prediction model was 0.868(95％CI:0.808-0.929).Calibration curve analysis showed that the model obtained consistent predicted probability with actual probability,and decision curve analy-sis indicated that the model had good clinical benefit.Conclusion Baseline blood glucose,NT-proBNP,internal carotid artery occlusion,and thrombectomy≥3 attempts are independent risk factors for futile recanalization after mechanical thrombectomy in elderly AF patients.Our prediction model has good predictive performance and prediction accuracy,but its application still needs prospective research and external verification.
