ArticleFrontiers in neurology2025
Differential impact of deep intraparenchymal hyperdensities versus subarachnoid/cortical hyperdensities on futile reperfusion after mechanical thrombectomy: a propensity score-matched study.
Article in Frontiers in neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Despite successful mechanical thrombectomy (MT), futile reperfusion (FR) remains a major challenge in acute ischemic stroke (AIS). While post-MT hyperdense areas (HDAs) on non-contrast computed tomography (CT) are associated with reperfusion injury, the differential effects of anatomical HDA subtypes-deep intraparenchymal (DIH) versus subarachnoid/cortical (SCH)-on FR risk are unclear. Methods: We retrospectively analyzed 864 AIS patients undergoing MT (2017-2023). HDAs detected within 0.5 h post-MT were classified as DIH or SCH. Propensity score matching (PSM) balanced baseline confounders (1:1 DIH: SCH). Risk factors for FR were analyzed using a multivariate logistic regression analysis in the PSM cohort. Results: After PSM, 116 patients in the DIH group were matched with 116 patients in the SCH group. In total, 91 patients (78.5%) in the SCH group and 72 patients (62.1%) in the DIH group suffered FR ( Conclusion: Anatomical HDA subtypes differentially predict FR risk, with SCH portending a worse prognosis. This subtype classification enables early risk stratification and may guide personalized post-MT management.
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