Red Cell Distribution Width and Futile Recanalization in Individuals with Acute Ischemic Stroke following Endovascular Treatment.

Background: Previous studies reported that red cell distribution width (RDW) was related to acute ischemic stroke (AIS). Endovascular treatment (EVT) still faces a huge challenge: futile recanalization. The goal of our study was to investigate the relationship between futile recanalization and RDW in AIS patients receiving EVT.

Methods: We retrospectively identified 188 AIS individuals with anterior circulation occlusion throughout EVT and obtained complete or near-total recanalization. The subjects were classified into futile recanalization group by their 3-month modified Rankin scale (mRS) score ≥3. The predictive value of RDW was calculated using receiver operating characteristic (ROC) curves, area under the curve (AUC) values, and logistic regression approaches.

Results: One hundred and eleven (59.0%) patients were defined as futile recanalization. The RDW was observed as an novel factor of futile recanalization in the multivariate regression model ([OR, odd-ratio] = 5.233, 95% [CI, confidence interval] = 2.656-10.307; p < 0.001). According to the ROC, the model integrating RDW with other risk factors had a relatively higher AUC compared than the RDW alone model (0.944 vs 0.798; p < 0.001) via DeLong's test.

Conclusions: Higher RDW is associated with poor functional outcome in anterior circulation AIS patients undergoing EVT at 3 months.