Real-world functional outcomes and predictors of futile recanalization in patients meeting criteria for SELECT2
Bibliographic record
Abstract
Background Recent randomized trials have shown that patients presenting with large core infarctions benefit from endovascular thrombectomy compared to medical management. We report real-world outcomes and factors associated with futile recanalization in patients meeting large core criteria for SELECT2. Methods Retrospective review of health system records from 1/1/2024 to 12/31/2024 for patients presenting with computed tomography (CT) Alberta Stroke Program Early CT Score (ASPECTS) 3–5 or CT perfusion (CTP) core infarction ≥50 milliliters. Primary and secondary outcomes, 90-day modified Rankin Scale (mRS) score 0–2 and 0–3, respectively, were compared to rates reported in SELECT2. Logistic regression was used to identify factors independently associated with 90-day mRS 5–6 despite successful reperfusion (modified treatment in cerebral ischemia 2b-3). Results Among 59 patients with 90-day outcome data, median CT ASPECTS and CTP core were 7 (5–10) and 78.5 (57–119) mL, respectively. Twelve (20.3%) achieved mRS 0–2, while 18 (30.5%) were ambulatory (mRS 0–3). Recanalization was achieved in 51 subjects, of whom 27 (52.9%) had a devastating neurological outcome (mRS 5–6). Atrial fibrillation was the only factor independently associated with futile recanalization (odds ratio 13.5, 95% confidence interval 1.4–128.8, p < 0.05). Conclusion Our real-world cohort of large core thrombectomy patients from daily clinical practice had identical rates of independent neurological function and lower ambulatory rates at 90 days to that reported in the treatment arm of SELECT2. A history of atrial fibrillation, independent of age and presenting stroke severity, was associated with futile recanalization.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".