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Japanese Journal of Radiology

03-05-2024 | Thrombectomy | Original Article

A clinical and computed tomography-based nomogram to predict the outcome in patients with anterior circulation large vessel occlusion after endovascular mechanical thrombectomy

Authors: Tiegong Wang, Xiangyu Jin, Panpan Yang, Shuai Li, Qianwen Zhang, Chengwei Shao, Jianping Lu, Xianglan Jin, Luguang Chen

Published in: Japanese Journal of Radiology

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Abstract

Purpose

To explore the positive predictors of the clinical outcome in acute ischemic stroke (AIS) patients with anterior circulation large vessel occlusion (ACLVO) after endovascular mechanical thrombectomy (EMT) at a 90-day follow-up, and to establish a nomogram model to predict the clinical outcome.

Materials and methods

AIS patients with ACLVO detected by multimodal Computed Tomography imaging who underwent EMT were collected. Patients were divided into the favorable and the unfavorable groups according to the 90-day modified Rankin Scale (mRS) score. Univariate and multivariate analyses were performed to investigate predictors of the favorable outcome (mRS of 0–2). A nomogram model for predicting the clinical outcome after EMT was drawn, and the receiver operating characteristic (ROC) curve was used to evaluate its predictive value.

Results

Totally 105 patients including 65 patients in the favorable group and 40 in the unfavorable group were enrolled. Multivariate logistic regression analysis showed that admission National Institute of Health Stroke scale (NIHSS) score [0.858 (95% CI 0.778–0.947)], ACLVO at M2 [20.023 (95% CI 2.204–181.907)] and infarct core (IC) volume [0.943 (95% CI 0.917–0.969)] was positively correlated with favorable outcome. The accuracy of the nomogram model in predicting the outcome was 0.923 (95% CI 0.870–0.976), with a cutoff value of 119.6 points. The area under the ROC curve was 0.848 (95% CI 0.780–0.917; sensitivity, 79.7%; specificity, 90.0%).

Conclusion

A low Admission NIHSS score, ACLVO at M2, and a small IC volume were positive predictors for favorable outcome. The nomogram model may well predict the outcome in AIS patients with ACLVO after EMT.
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Metadata
Title
A clinical and computed tomography-based nomogram to predict the outcome in patients with anterior circulation large vessel occlusion after endovascular mechanical thrombectomy
Authors
Tiegong Wang
Xiangyu Jin
Panpan Yang
Shuai Li
Qianwen Zhang
Chengwei Shao
Jianping Lu
Xianglan Jin
Luguang Chen
Publication date
03-05-2024
Publisher
Springer Nature Singapore
Published in
Japanese Journal of Radiology
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI
https://doi.org/10.1007/s11604-024-01583-7