Objective To explore the influencing factors for futile recanalization after mechanical thrombectomy for acute basilar artery occlusion(BAO),and establish a clinical prediction model,so as to provide evidence for the management of patients with posterior circulation acute cerebral infarction.Methods This study was a retrospective a-nalysis of the Acute Basilar Artery Occlusion Endovascular Treatment Randomized Controlled Trial(ATTENTION).The study was conducted from February 2021 to January 2022 at 36 medical centers in China.Two hundred and four patients who underwent mechanical thrombectomy in ATTENTION trial were recruited and divided into the effective recanaliza-tion group(n=72)and the futile recanalization group(n=132)according to whether futile recanalization occurred at 3 months.Multivariate logistic regression was used to analyze the independent risk factors for futile recanalization after mechanical thrombectomy in patients with acute BAO.The efficiency of the model was evaluated by receiver operating characteristic(ROC)curve,Hosmer-Lemeshow test(HL test)and decision curve analysis(DC A curve).Results Compared with the effective recanalization group,patients in the futile recanalization group were older,and had longer puncture to vascular recanalization time(PTR),as well as higher baseline NIHSS score,with significant differences(P＜0.05).According to multivariate logistic regression analysis,age,baseline NIHSS score and PTR were the inde-pendent predictors of futile recanalization after mechanical thrombectomy for acute BAO.Variables in the final model in-cluded age,baseline NIHSS score,PTR,and white blood cell count(WBC).As revealed by internal validation results,the area under the curve(AUC)of the model in predicting the risk of futile recanalization was 0.755.When the risk threshold of the model in predicting the risk of futile recanalization after mechanical thrombectomy in acute BAO patients was＞0.28,the model provided a clinical net benefit.Conclusions Age,baseline NIHSS score,and PTR are the inde-pendent predictors of futile recanalization after mechanical thrombectomy in patients with acute BAO,and the Nomogram model established in this study has good predictive value.
维普
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