Early Post‐Operative Quantitative
EEG
Central Beta Power Predicts Futile Recanalization After Endovascular Treatment in
AIS
‐
Ji‐Ru Cai, Feng Xue, Zi‐Ai Zhao, Hui‐Sheng Chen
ABSTRACT
Background and Purpose
Despite successful endovascular recanalization in acute ischemic stroke, approximately 50%–55% of patients experience 90‐day futile recanalization (FR). We evaluated the prognostic value of central relative beta power derived from early postoperative quantitative electroencephalography (QEEG) and explored QEEG associations with brain edema and parenchymal hemorrhage.
Methods
This retrospective, single‐center subgroup analysis of the prospective multicenter DETECT2‐China registry included 56 patients with acute ischemic stroke due to large‐vessel occlusion. Patients underwent 20–30‐min EEG recordings approximately 24 h after successful endovascular treatment. Multivariable logistic regression adjusting for seven clinical covariates, Firth and reduced‐model sensitivity analyses, and leave‐one‐out cross‐validation (LOOCV) with the DeLong test were performed. An additional sensitivity analysis repeated QEEG feature selection within each training set. Feature reliability was evaluated using split‐half intraclass correlation coefficients (ICCs).
Results
Of 56 patients, 31 (55.4%) developed 90‐day FR. Higher central relative beta power was independently associated with lower odds of FR (adjusted OR: 0.28 per 1‐SD increase, 95% CI: 0.11–0.74, p = 0.010). Integrating central beta power into the clinical model increased the fixed‐feature LOOCV area under the receiver operating characteristic curve (AUC) from 0.557 to 0.719 (DeLong p = 0.007). In exploratory analyses, delta‐band Brain Symmetry Index specifically tracked parenchymal hemorrhage (PH vs. no intracranial hemorrhage [No ICH], p = 0.006). Exploratory graph analysis also showed macro‐scale network disintegration in FR patients. All QEEG features demonstrated high split‐half reliability (ICC ≥ 0.75).
Conclusions
Central relative beta power recorded approximately 24 h after endovascular treatment was independently associated with 90‐day FR and showed potential incremental prognostic value. Exploratory associations with postoperative complications suggest that QEEG may provide a non‐invasive bedside “brain window” for neurocritical care.