The authors' purpose was to develop and validate a predictive model for futile recanalization after EVT by integrating arterial-venous collateral assessment with clinical parameters. Patients were stratified into training, internal validation, and completely independent external validation cohorts collected from a separate medical center. Three independent predictors were identified: age, whole-brain arterial collateral status, and whole-brain venous collateral status. The model demonstrated excellent discrimination in the training cohort, internal validation cohort, and notably maintained robust performance in the completely independent external validation cohort. The integration of whole-brain arterial-venous collateral assessment with clinical parameters shows potential value in predicting futile recanalization after EVT. This model, validated across multiple cohorts, may provide additional information to support clinical decision-making.
