Futile recanalisation in patients with anterior large vessel occlusion stroke randomised to mechanical thrombectomy

Author: Handelsmann HL, Herzog L, Hoving AJ, Majoie C, Van Zwam W, Van der Lugt A, Wegener S, MR CLEAN Investigators.

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Journal of the Neurological Sciences | Futile recanalisation in patients with anterior large vessel occlusion stroke randomised to mechanical thrombectomy

Article Link: https://doi.org/10.1016/j.jns.2026.125772

Up to half of patients with large vessel occlusion (LVO) stroke experience futile recanalisation (FR) despite successful mechanical thrombectomy (MT). In a retrospective analysis of the MR CLEAN cohort (n=461), predictors of treatment response, vessel recanalisation, and FR were examined.

Among 195 patients randomised to MT, male sex enhanced treatment benefit, while shorter onset-to-groin time was associated with successful recanalisation. Higher age and poor collateral status were linked to FR, with female sex and worse collaterals showing the strongest predictive value. These readily available acute clinical factors may help identify patients at risk of futile recanalisation.

Read the full article to explore how patient characteristics influence both technical and clinical success after thrombectomy.