Relationship between first pass effect NLR and PLR in mechanical thrombectomy for acute anterior circulation large-vessel occlusion

PurposeThe study investigated the correlation between the neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR) concerning the first-pass effect (FPE) observed during mechanical thrombectomy subsequent to acute ischemic stroke (AIS).MethodsPatients diagnosed with AIS in the anter...

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Main Authors: Guozhang Lu, Peijian Wang, Bin Xv, Hang Lv, Liyong Zhang, Jiyue Wang, Jiheng Hao
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1490127/full
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author Guozhang Lu
Peijian Wang
Bin Xv
Hang Lv
Liyong Zhang
Jiyue Wang
Jiheng Hao
author_facet Guozhang Lu
Peijian Wang
Bin Xv
Hang Lv
Liyong Zhang
Jiyue Wang
Jiheng Hao
author_sort Guozhang Lu
collection DOAJ
description PurposeThe study investigated the correlation between the neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR) concerning the first-pass effect (FPE) observed during mechanical thrombectomy subsequent to acute ischemic stroke (AIS).MethodsPatients diagnosed with AIS in the anterior circulation, who underwent mechanical thrombectomy between January 2020 and December 2022, were assessed. Various data were collected, including blood cell counts, general information, relevant surgical and clinical details, and functional outcomes determined by the Modified Rankin Scale (MRS) score ≤2 at 3 months. Logistic regression was utilized to identify independent factors predicting the first-pass effect (FPE) and to explore the associations between FPE and the NLR and PLR. Critical NLR and PLR values were examined using Receiver-operating characteristics (ROC) curves.ResultsA total of 233 patients were enrolled and categorized into either the FPE or MPE groups based on the success of the initial thrombectomy. The FPE group showed significant distinctions compared to the MPE group in both NLR and PLR levels: NLR (3.63 vs. 4.90, p < 0.001), PLR (134.92 vs. 164.77, p = 0.001). Both univariate and multivariate regression analyses demonstrated the independent predictive ability of NLR and PLR for assessing the risk of FPE during mechanical thrombectomy, with NLR (Adjusted Odds ratio (OR) 0.764; 95% CI 0.665–0.878, p = 0.001) and PLR (Adjusted OR0.993; 95% CI 0.989–0.998, p = 0.002). Moreover, the ROC curves delineated critical threshold values of 4.34 and 148.03 for NLR and PLR, respectively.ConclusionThe increase of NLR and PLR may be related to the failure of FPE.
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spelling doaj-art-a0a7640a783441a489b117bfe9f0da2a2025-08-20T03:29:19ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-07-011610.3389/fneur.2025.14901271490127Relationship between first pass effect NLR and PLR in mechanical thrombectomy for acute anterior circulation large-vessel occlusionGuozhang Lu0Peijian Wang1Bin Xv2Hang Lv3Liyong Zhang4Jiyue Wang5Jiheng Hao6Department of Neurosurgery, Liaocheng People’s Hospital, Liaocheng, ChinaDepartment of Neurosurgery, Liaocheng People’s Hospital, Liaocheng, ChinaSchool of Clinical Medicine, Weifang Medical University, Weifang, ChinaDepartment of Neurosurgery, XD Group Hospital, Xian, ChinaDepartment of Neurosurgery, Liaocheng People’s Hospital, Liaocheng, ChinaDepartment of Neurosurgery, Liaocheng People’s Hospital, Liaocheng, ChinaDepartment of Neurosurgery, Liaocheng People’s Hospital, Liaocheng, ChinaPurposeThe study investigated the correlation between the neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR) concerning the first-pass effect (FPE) observed during mechanical thrombectomy subsequent to acute ischemic stroke (AIS).MethodsPatients diagnosed with AIS in the anterior circulation, who underwent mechanical thrombectomy between January 2020 and December 2022, were assessed. Various data were collected, including blood cell counts, general information, relevant surgical and clinical details, and functional outcomes determined by the Modified Rankin Scale (MRS) score ≤2 at 3 months. Logistic regression was utilized to identify independent factors predicting the first-pass effect (FPE) and to explore the associations between FPE and the NLR and PLR. Critical NLR and PLR values were examined using Receiver-operating characteristics (ROC) curves.ResultsA total of 233 patients were enrolled and categorized into either the FPE or MPE groups based on the success of the initial thrombectomy. The FPE group showed significant distinctions compared to the MPE group in both NLR and PLR levels: NLR (3.63 vs. 4.90, p < 0.001), PLR (134.92 vs. 164.77, p = 0.001). Both univariate and multivariate regression analyses demonstrated the independent predictive ability of NLR and PLR for assessing the risk of FPE during mechanical thrombectomy, with NLR (Adjusted Odds ratio (OR) 0.764; 95% CI 0.665–0.878, p = 0.001) and PLR (Adjusted OR0.993; 95% CI 0.989–0.998, p = 0.002). Moreover, the ROC curves delineated critical threshold values of 4.34 and 148.03 for NLR and PLR, respectively.ConclusionThe increase of NLR and PLR may be related to the failure of FPE.https://www.frontiersin.org/articles/10.3389/fneur.2025.1490127/fullmechanical thrombectomyfirst pass effectneutrophil-lymphocyte ratioplatelet-lymphocyte ratioacute anterior circulation large-vessel occlusion
spellingShingle Guozhang Lu
Peijian Wang
Bin Xv
Hang Lv
Liyong Zhang
Jiyue Wang
Jiheng Hao
Relationship between first pass effect NLR and PLR in mechanical thrombectomy for acute anterior circulation large-vessel occlusion
Frontiers in Neurology
mechanical thrombectomy
first pass effect
neutrophil-lymphocyte ratio
platelet-lymphocyte ratio
acute anterior circulation large-vessel occlusion
title Relationship between first pass effect NLR and PLR in mechanical thrombectomy for acute anterior circulation large-vessel occlusion
title_full Relationship between first pass effect NLR and PLR in mechanical thrombectomy for acute anterior circulation large-vessel occlusion
title_fullStr Relationship between first pass effect NLR and PLR in mechanical thrombectomy for acute anterior circulation large-vessel occlusion
title_full_unstemmed Relationship between first pass effect NLR and PLR in mechanical thrombectomy for acute anterior circulation large-vessel occlusion
title_short Relationship between first pass effect NLR and PLR in mechanical thrombectomy for acute anterior circulation large-vessel occlusion
title_sort relationship between first pass effect nlr and plr in mechanical thrombectomy for acute anterior circulation large vessel occlusion
topic mechanical thrombectomy
first pass effect
neutrophil-lymphocyte ratio
platelet-lymphocyte ratio
acute anterior circulation large-vessel occlusion
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1490127/full
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