Quantitative EEG Prediction Of Futile Recanalization After Thrombectomy In Acute Ischemic Stroke

Objective:Previous studies have reported that parameters of Quantitative EEG are associated with Acute Ischemic Stroke(AIS).The relationship between parameters of Quantitative electroencephalogram(QEEG)and clinical outcomes in patients with complete recanalization of AIS endovascular thrombectomy has been rarely reported.The purpose of this study was to evaluate the quantitative EEG parameter-regional delta-alpha power ratio(DAR)and futile recanalization(FR)in AIS patients with large vessel occlusion in the anterior circulation after mechanical thrombectomy relationship.Methods:A retrospective study was performed on AIS patients with anterior circulation large artery occlusion with complete recanalization(mTICI grade 2b or 3)after mechanical thrombectomy from May 2020 to October 2021.The patients with complete recanalization were divided into effective recanalization group and ineffective recanalization group according to the 3-month modified Rankin scale score.The futile recanalization group was defined as a 3-month modified mRS score of 3-6,and the futile recanalization group was defined as a 3-month modified mRS score of 0-2.Univariate analysis was used to screen the related risk factors of FR(P<0.05),and the factors with P<0.05 were analyzed by binary logistic regression to determine the independent risk factors of futile recanalization.The receiver operating characteristic curve was used to evaluate the predictive value of risk factors for ineffective recanalization.Results:Among the 152 patients,81 patients underwent effective recanalization,and 71 were ineffective recanalization,with an futile recanalization rate of 46.7%.In univariate analysis,the baseline characteristics of admission NHISS score,neutrophil ratio,hemorrhagic transformation rate,number of thrombectomy,and opening time were higher than those in the effective recanalization group,and the ASPECTS score was lower than that in the effective recanalization group,all of which were statistically significant(P<0.05).In the electrophysiological characteristics,the baseline values of DAR in the frontal area and temporal area of the affected side in the ineffective recanalization group were higher than those in the effective recanalization group,all of which were statistically significant(P<0.05).After adjusting for potential confounders,the multivariate adjusted regression model showed regional DAR(odds ratio,1.205[95%CI 1.041-1.396],P=0.013),neutrophil ratio(odds ratio,1.040[95%CI],P=0.013 1.040-1.081],P=0.042),ASPECTS score(odds ratio,0.556[95%CI 0.397-0.780],P=0.001),admission NHISS score(odds ratio,1.209[95%CI 1.064-1.373],P=0.004)was an independent predictor of ineffective recanalization.Receiver operating characteristic curve analysis showed that a model combining regional DAR,especially temporal DAR,and other clinical factors could effectively predict poor prognosis.Conclusion:Regional DAR,especially temporal DAR,is associated with poor prognosis 3 months after mechanical thrombectomy in AIS patients with anterior circulation large vessel occlusion,and a model combined with temporal DAR can effectively predict poor prognosis.