Baseline predictors of poor clinical outcome despite recanalization of distal middle cerebral artery occlusions.
Publication/Presentation Date
7-16-2025
Abstract
ObjectiveMechanical thrombectomy (MT) is well-established for the treatment of acute ischemic stroke (AIS) from large vessel occlusion (LVO), with growing data supporting the expansion to distal and medium vessel occlusions (DMVO). Despite successful recanalization in DMVO, certain patients still experience poor long-term clinical outcomes, prompting our study to comprehensively explore pre-MT factors influencing outcome despite excellent recanalization (final modified Thrombolysis in Cerebral Infarction [mTICI] score ≥2c).MethodsWe retrospectively examined data from patients who consecutively underwent MT for a primary middle cerebral artery (MCA) DMVO across 37 centers in North America, Asia, and Europe. We identified baseline clinical and imaging factors associated with poor clinical outcome (defined as a modified Rankin Scale [mRS] score of 3-6) at 3 months, despite excellent recanalization using a multivariable model.ResultsBetween September 2017 and July 2021, 623 patients achieved mTICI > 2b and they were included in our study. Among them, 198 (32%) experienced a poor clinical outcome (mRS 3-6). Predictors of poor clinical outcome included higher age (OR 1.05 [1.03-1.07],
First Page
15910199251342841
Last Page
15910199251342841
ISSN
2385-2011
Published In/Presented At
Chafai, I., Salim, H., Musmar, B., Adeeb, N., Yedavalli, V., ElNaamani, K., Henninger, N., Nedelcu, S., Sundararajan, S. H., Kühn, A. L., Khalife, J., Ghozy, S., Scarcia, L., Tan, B. Y., Heit, J. J., Regenhardt, R. W., Cancelliere, N. M., Bernstock, J. D., Rouchaud, A., Fiehler, J., … MAD MT Investigators ## (2025). Baseline predictors of poor clinical outcome despite recanalization of distal middle cerebral artery occlusions. Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, 15910199251342841. Advance online publication. https://doi.org/10.1177/15910199251342841
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
40665742
Department(s)
Administration and Leadership
Document Type
Article