Objectives To identify the occurrence rate and predictors of futile recanalisation after endovascular therapy (EVT) for acute vertebrobasilar artery occlusion (VBAO). Methods Participants of the Endovascular Treatment Key Technique and Emergency Workflow Improvement of Acute Ischaemic Stroke (ANGEL-ACT) registry were selected for the analysis. Futile recanalisation was defined as patients did not achieve a 90-day good outcome (modified Rankin Scale ≤3) despite successful recanalisation (modified Treatment in Cerebral Ischaemia Scale ≥2b) after the procedure. Multivariable logistic regression analysis was conducted to find independent predictors of futile recanalisation in VBAO patients undergoing EVT. Results Three hundred and fifteen patients with VBAO who achieved successful recanalisation after EVT were included in current analysis, of whom, 155 (49.2%) suffered futile recanalisation, and 160 achieved effective recanalisation. After the multivariable analysis, we found admission National Institutes of Health Stroke Scale (NIHSS) ≥19 (OR 4.81, 95% CI 2.76 to 8.39, p<0.001), platelet-lymphocyte ratio (PLR) ≥162.2 (OR 1.93, 95% CI 1.14 to 3.27, p=0.001), onset-to-puncture time (OTP) ≥334 min (OR 2.15, 95% CI 1.25 to 3.68, p=0.005) and use of general anesthesia (GA) (OR 1.87, 95% CI 1.09 to 3.22, p=0.024) were associated with futile recanalisation. Conclusions Futile recanalisation after EVT occurred 49.2% of VBAO patients in the ANGEL-ACT registry. NIHSS≥19, PLR≥162.2, OTP≥334 min and use of GA were independent predictors of futile recanalisation. Data are available on reasonable request.

中文翻译：

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急性椎基底动脉闭塞患者血管内治疗后无效再通的发生率和预测因素：来自 ANGEL-ACT 登记的见解

目的 确定急性椎基底动脉闭塞 (VBAO) 血管内治疗 (EVT) 后无效再通的发生率和预测因素。方法选择急性缺血性脑卒中血管内治疗关键技术和急诊工作流程改进（ANGEL-ACT）注册中心的参与者进行分析。无效再通定义为尽管术后成功再通（改良脑缺血量表≥2b），但患者未达到 90 天良好结局（改良Rankin 量表≤3）。进行多变量逻辑回归分析，以寻找接受 EVT 的 VBAO 患者无效再通的独立预测因子。结果 本次分析纳入了 315 例 EVT 后成功再通的 VBAO 患者，其中 155 例（49.2%）再通无效，160 例实现有效再通。经过多变量分析，我们发现入院时美国国立卫生研究院卒中量表（NIHSS）≥19（OR 4.81，95% CI 2.76至8.39，p<0.001），血小板淋巴细胞比值（PLR）≥162.2（OR 1.93，95%） CI 1.14 至 3.27，p=0.001），起效至穿刺时间 (OTP) ≥334 分钟（OR 2.15，95% CI 1.25 至 3.68，p=0.005）以及使用全身麻醉 (GA)（OR 1.87，95） % CI（1.09 至 3.22，p=0.024）与无效的再通相关。结论 ANGEL-ACT 登记中 49.2% 的 VBAO 患者发生 EVT 后无效再通。NIHSS≥19、PLR≥162.2、OTP≥334 分钟和使用 GA 是无效再通的独立预测因素。可根据合理要求提供数据。