STRIVE-2 MRI-Defined Brain Frailty and Functional Outcomes After Thrombectomy: A Multicenter Study

Q: What does this research mean for the field?

Preexisting cerebral small vessel disease (CSVD) markers, particularly lacunes, atrophy, and white matter hyperintensities, as well as cumulative CSVD burden, independently predict worse functional recovery and symptomatic hemorrhage after mechanical thrombectomy for large vessel occlusion stroke. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Thiago Oscar Goulart; Markus Schirmer; Yuan Ma; Anna K. Bonkhoff; Erik Lindgren; Penina Krieger; Ben Teasdale; Alvin S. Das; Adam A. Dmytriw; James Rabinov; Christopher J. Stapleton; Aman B. Patel; Vincent Tutino; Michael Nahhas; Sunil A Sheth; Claus Z. Simonsen; Natalia Rost; Robert W. Regenhardt

doi:10.1177/17474930261490798

Key Points

To determine whether pre-treatment MRI markers of cerebral small vessel disease predict 90-day functional outcomes and hemorrhagic transformation following mechanical thrombectomy for large vessel occlusion stroke.
Retrospective multicenter cohort study analyzing 479 consecutive patients with anterior circulation large vessel occlusion treated with mechanical thrombectomy between 2015 and 2022 at two tertiary centers.
Pre-treatment MRI scans were assessed for STRIVE-2 cerebral small vessel disease features, including white matter hyperintensities, lacunes, cerebral microbleeds, enlarged perivascular spaces, and brain atrophy.
Bayesian logistic regression models adjusted for age, sex, thrombolysis, infarct volume, time-to-puncture, and reperfusion status to determine adjusted odds ratios (aOR) for 90-day functional dependence or death (mRS 3-6) and symptomatic intracerebral hemorrhage.
At 90 days, 47% of patients experienced functional dependence or death, which was independently associated with lacunes (aOR 2.07; 95% CrI 1.22–3.59; posterior probability >99%), moderate-to-severe brain atrophy (aOR 1.92; 95% CrI 1.09–3.40; PP 99%), and moderate-to-severe white matter hyperintensities (aOR 1.63; 95% CrI 0.94–2.84; PP 96%).
Each 1-point increase in the 5-item composite cerebral small vessel disease score demonstrated a dose-dependent increase in functional dependence (aOR 1.44; 95% CrI 1.23–1.69; PP >99%) and symptomatic intracerebral hemorrhage (aOR 1.33; 95% CrI 0.92–1.93; PP 94%).

No abstract yet

We only have this paper's title and publication details.

Read it at the source

Implication

Multicenter cohort study reveals higher disability and hemorrhage risk after thrombectomy in stroke patients with cerebral small vessel disease, indicating brain frailty impairs recovery.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Goulart et al. (2026) studied this question.

synapsesocial.com/papers/6aa7b3bf0926e14a848b2f42 https://doi.org/10.1177/17474930261490798

View Full Paper

Ask AI

Bookmark

Share

STRIVE-2 MRI-Defined Brain Frailty and Functional Outcomes After Thrombectomy: A Multicenter Study

Key Points

No abstract yet

Implication

Discussion

Cite This Study

STRIVE-2 MRI-Defined Brain Frailty and Functional Outcomes After Thrombectomy: A Multicenter Study

Key Points

No abstract yet

Implication

Discussion

Cite This Study

Keep reading

Keep reading