To determine whether automated net water uptake (NWU) measured on admission non-contrast computed tomography (CT) independently predicts futile recanalization (FR) in anterior-circulation large vessel occlusion (LVO) stroke treated with endovascular thrombectomy (EVT).
Approach:
Study Design: Retrospective single-center cohort study including patients with anterior circulation LVO treated with EVT from January 2023 to April 2025.
Data Collection: Automated platform (VEOcore/MRAY) provided Alberta Stroke Program Early CT Score (ASPECTS), perfusion metrics, and NWU.
Statistical Analysis: Logistic regression analyzed associations with FR; ROC analysis evaluated discrimination and identified optimal NWU thresholds.
Key Findings:
62 out of 91 patients (68.1%) achieved recanalization with a 90-day modified Rankin Scale (mRS) score of 0–4.
29 patients (31.9%) met criteria for FR (mRS score 5–6).
Patients with FR were older (81.6 ± 8.3 years) and had more severe strokes (median NIHSS score of 16).
NWU was significantly higher in FR cases (21.9%) compared to non-FR cases (3.0%).
NWU remained independently associated with FR (odds ratio 1.15).
Interpretation:
Limitations:
Single-center study may limit generalizability.
Retrospective design may introduce selection bias.
Conclusion:
Automated NWU measurement may warrant prospective multicenter validation.
by Abdallah Aburub, Oussama Dob, Mariana Gurschi, Yashar Aghazadeh, Jumana Jaber, Zaid Al-Tamimi, Zaid Samhan, Lars Timmermann, Christopher Nimsky, Peter Sporns, Gabriel Broocks, André Kemmling
