The role of serum biomarkers in predicting futile recanalization and functional outcome in patients with ischemic stroke undergoing mechanical thrombectomy.
DOI:
https://doi.org/10.52692/1857-0011.2025.3-83.38Keywords:
acute ischemic stroke, mechanical thrombectomy, futile recanalization, biomarkers, CRP, NLR, D-dimers, MMP-9Abstract
Introduction: Despite the technical success of mechanical thrombectomy (MT) in patients with acute ischemic stroke due to large vessel occlusion, over 60% of patients remain with poor functional outcomes (“futile recanalization”). Early identification of high-risk patients represents a clinical priority.
Objective: To provide a narrative review of the literature regarding the predictive value of serum biomarkers (inflammatory, hemostatic, and blood–brain barrier integrity markers) for futile recanalization and neurological outcomes. Materials and methods: A narrative literature review was conducted using the PubMed database, employing both free keywords (“ischemic stroke,” “thrombectomy,” “biomarkers,” “prediction”) and corresponding MeSH terms, covering
the period 2016–2025. A total of 2.043 publications were identified, with 46 studies included in the final analysis.
Results: C-reactive protein and the neutrophil-to-lymphocyte ratio were found to be independent predictors of 3-month mortality and disability after MT. D-dimers and thrombocytopenia were associated with poor prognosis, while MMP-9, S100B, and NfL provided information on blood–brain barrier disruption and neuronal injury, with variable prognostic significance. Integrating these biomarkers into a multiparametric panel may enhance risk stratification accuracy.
Conclusions: Serum biomarkers may complement clinical and imaging parameters, providing a valuable tool for identifying patients at high risk of futile recanalization and for developing personalized therapeutic strategies.
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