The potential of biomarkers to predict futile recanalization in stroke patients receiving endovascular treatment
Firat Karaaslan1
, Reşit Yilmaz1, Fidel Demir2, Müttalip Özbek3, İbrahim Kaplan4, Eşref Akil5
1Department of Neurology, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Türkiye
2Department of Neurology, Selahaddin Eyyubi State Hospital, Diyarbakır, Türkiye
3Department of Neurology, Kızıltepe State Hospital, Mardin, Türkiye
4Department of Biochemistry, Dicle University Faculty of Medicine, Diyarbakır, Türkiye
5Department of Neurology, Dicle University Faculty of Medicine, Diyarbakır, Türkiye
Keywords: Acute ischemic stroke, biomarkers, clinical outcome, endovascular treatment, futile recanalization.
Abstract
Objectives: This study aimed to investigate the relationships between serum S100 calcium binding protein, neuron-specific enolase, matrix metalloproteinase-9, interleukin-6, N-terminal probrain natriuretic peptide, and N-methyl-D-aspartate receptor subunit NR2 biomarkers and futile recanalization in patients with acute ischemic stroke who were successfully recanalized with endovascular treatment.
Patients and methods: In this study, 44 patients (25 males, 19 females; mean age: 62.2±14.1 years; range, 26 to 81 years) with acute ischemic stroke due to acute anterior circulation large-vessel occlusion were prospectively analyzed between May 15, 2020 and October 15, 2020. Blood samples were taken at admission, as well as 6 and 24 h after endovascular treatment. A modified Rankin Scale (mRS) was used on the 90th day to identify futile reperfusion. Patients with mRS scores ≤2 were included in the favorable reperfusion group (n=20), while patients with mRS scores ≥3 were considered to exhibit futile reperfusion (n=24).
Results: There were no significant differences between the biomarker levels of the groups (p>0.05). There was no statistically significant correlation between biomarkers and 90-day mRS scores (p>0.05). Higher National Institute of Health Stroke Scale (NIHSS) scores (p=0.004), higher number of retriever passes (p=0.032), and higher diastolic blood pressure (p=0.037) were associated with futile recanalization. Multivariate logistic regression analysis showed that a higher NIHSS score at admission was an independent predictor of futile recanalization (odds ratio=1.216, 95% confidence interval 1.01-1.46, p=0.038).
Conclusion: A higher NIHSS score at admission was an independent predictor for futile recanalization. However, we concluded that biomarker levels were not associated with futile recanalization.
Cite this article as: Karaaslan F, Yilmaz R, Demir F, Özbek M, Kaplan İ, Akil E. The potential of biomarkers to predict futile recanalization in stroke patients receiving endovascular treatment. Turk J Neurol 2025;31(1):16-24. doi: 10.55697/tnd.2025.216
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Idea/concept, design, data collection and/or processing, literature review, writing the article, references and fundings, materials: F.K.; Idea/concept, design, control/supervision, critical review, materials, data collection and/or processing, literature review: R.Y.; Idea/concept, design, control/supervision, critical review, literature review: F.D.; Control/supervision, critical review, materials, data collection and/or processing: M.Ö.; Design, critical review, references and fundings, materials: İ.K.; Idea/concept, design, control/supervision, analysis and/or, interpretation, literature review, critical review, references and fundings, materials: E.A.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.