Determinants of Futile Recanalization and the Influence of Age After Endovascular Therapy for Acute Ischemic Stroke: A Retrospective Single-Center Cohort Study

Background and Objectives: Functional independence is not always achieved after successful recanalization with endovascular therapy (EVT) for acute ischemic stroke, a phenomenon termed futile recanalization (FR). We investigated factors independently associated with FR and explored whether these associations differed by age. Materials and Methods: In this retrospective single-center study, 231 consecutive patients treated with EVT between January 2021 and December 2024 were analyzed. FR was defined as a modified Rankin Scale score > 2 at 90 days despite a modified Thrombolysis in Cerebral Infarction (mTICI) grade of 2b-3. Model 1 included all patients with successful recanalization. Model 2 was restricted to patients with anterior circulation infarction and assessable imaging and additionally included the Alberta Stroke Program Early CT Score (ASPECTS) and collateral status. Age interactions were tested.