Comparative Analysis of Endovascular Treatment Outcomes in Acute Large Vessel Occlusion Strokes

Objectives: Intracranial atherosclerotic disease (ICAD) is a common cause of ischemic stroke worldwide. We assessed the clinical outcomes of endovascular treatment in acute large vessel occlusion (LVO) strokes caused by ICAD and compared them with large vessel occlusion strokes not associated with intracranial atherosclerosis (non-ICAD LVO). Methods: We included consecutive adult patients diagnosed with LVO stroke who underwent endovascular therapy at Rhode Island Hospital from July 2015 to March 2023, and data were collected retrospectively. We compared baseline characteristics and outcomes, including recurrent in-hospital large vessel occlusion, disability, and mortality between these 2 groups (ICAD LVO vs. non-ICAD LVO). We used the t test, χ 2 , and Fisher exact tests were used for the comparison of groups and adjusted binary logistic regression to compare outcomes between the 2 groups. Results: Our study comprised 1390 adult patients diagnosed with LVO stroke who underwent endovascular therapy at Rhode Island Hospital from July 2015 to March 2023, and data were collected retrospectively. Among these, 68 patients were ICAD LVO, while 1322 individuals were categorized as non-ICAD LVO. In the ICAD-LVO group, 38 patients received stenting, while 30 did not, of whom 23 underwent angioplasty. Patients with ICAD LVO group had a higher odds of reocclusion during hospitalization (11.8% vs. 4%, P =0.008), but there was no significant difference in good 90-day functional outcome (mRS ≤2) (OR: 0.89; 95% CI: 0.45-1.79; P =0.749) and 90-day mortality rate (OR: 1.47; 95% CI: 0.69-3.14; P =0.320) between the ICAD LVO and non-ICAD LVO groups. Conclusions: Our study showed increased odds of reocclusion during hospitalization in the ICAD LVO group following endovascular therapy. However, we did not observe any statistically significant differences in measures of disability and mortality between the 2 groups.