A retrospective study of outcome predictive models for anterior circulation stroke post-endovascular thrombectomy: Are CT-derived morphomics useful?
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Date
2026-06-13
Authors
Manole, Constantin
Shet, Sahil
O'Brien, Alan
Kakish, Eid
O'Regan, Patrick
Maher, Michael M.
Kelly, Roisin
Hegarty, Aidan
Fanning, Noel
Ryan, David J.
Journal Title
Journal ISSN
Volume Title
Publisher
S. Karger AG
Published Version
Abstract
Introduction: In acute ischaemic stroke secondary to a large vessel occlusion, endovascular thrombectomy (EVT) is the standard of care. However, prediction of functional outcomes following EVT remains challenging. We sought to determine whether CT-derived morphomic data on body composition can improve outcome prediction following EVT. Methods: A retrospective analysis of anterior circulation stroke patients who underwent EVT between 2021 and 2023 at a single centre was conducted. Demographic, clinical, and morphomic data including neck muscle and fat area and density were collected. Multivariate logistic regression was used to develop pre-procedure and 24-h post-EVT models for predicting 90-day outcomes. A positive outcome was defined as a modified Rankin Scale (mRS) score of ≤2 at 90 days post-EVT. These models were subsequently tested on 2 separate validation cohorts. Results: High pre-procedure ASPECTS scores, lower baseline NIHSS scores, absence of post-procedure haemorrhage, younger age, and early neurological improvement were the strongest predictors of a positive outcome. None of the morphomic variables were significantly correlated with outcome. The 24-h model was highly accurate in predicting post-EVT outcomes in both validation cohorts. Conclusion: CT-derived morphomic variables did not significantly improve prediction of stroke outcomes post-EVT. Clinical and imaging variables (especially 24-h post-procedure data) showed high accuracy in predicting functional outcomes at 90 days.
Description
Keywords
Anterior circulation stroke , Endovascular thrombectomy , Morphomics , Risk prediction , [Medicine] , [Pharmacy]
Citation
Manole, C, Shet, S, O'Brien, A, Kakish, E, O'Regan, P, Maher, M M, Kelly, R, Hegarty, A, Fanning, N & Ryan, D J 2026, 'A retrospective study of outcome predictive models for anterior circulation stroke post-endovascular thrombectomy : Are CT-derived morphomics useful?', Acta Cytologica, vol. 16, no. 1, pp. 180-193. https://doi.org/10.1159/000550274