Key result
Higher ePWV linked to ~34% greater risk of poor 3-month post-thrombectomy outcome per m/s.
Why the study?
Estimated pulse wave velocity as a surrogate of arterial stiffness may influence stroke outcomes and collateral circulation after endovascular thrombectomy, but its associations were unclear.
Does higher estimated pulse wave velocity (ePWV) associate with poor collateral status and poor functional outcome in patients with acute ischemic stroke after successful endovascular thrombectomy?
Observational (n=285)
Blinded outcome assessment
Yes
Does higher estimated pulse wave velocity (ePWV) associate with poor collateral status and poor functional outcome in patients with acute ischemic stroke after successful endovascular thrombectomy?
Odds Ratio: 1.338 (95% CI 1.121–1.597)
p-value: p=0.001
Higher estimated pulse wave velocity is associated with poor functional outcome and poor collateral status following successful endovascular thrombectomy for acute ischemic stroke, independently of BP management strategy.
ePWV may risk-stratify post-thrombectomy patients; observational data leave open whether arterial stiffness is a modifiable target.
PURPOSE: Estimated pulse wave velocity (ePWV) is a surrogate of arterial stiffness that may influence stroke outcomes and potentially affect collateral circulation. We examined the association of ePWV with collateral status and 3-month functional outcome after successful endovascular thrombectomy and explored the contribution of collateral status to this relationship across blood pressure (BP) management strategies. MATERIALS AND METHODS: In this secondary analysis of the Outcome in Patients Treated With Intra-Arterial Thrombectomy-Optimal Blood Pressure Control trial, 285 patients were analyzed. Collateral status was assessed using the Tan scale (poor, 0-1; good, 2-3). Poor functional outcome was defined as 3-month modified Rankin Scale score of 3-6. Multivariable logistic and mediation analyses were performed to evaluate the association between ePWV and functional outcomes and to explore direct and indirect pathways. RESULTS: A total of 285 patients were included (mean age, 73.3±11.3 years; 40.4% women). Each 1 m/s increase in ePWV was associated with poor collaterals (adjusted odds ratio [OR] 1.276, 95% confidence interval [CI] 1.083-1.503) and poor functional outcome (adjusted OR 1.338, 95% CI 1.121-1.597). In mediation analyses, collateral status accounted for only a small proportion of the association between ePWV and poor functional outcome (indirect effect: adjusted β 0.022, 95% CI 0.001-0.053), whereas the direct effect remained significant (adjusted β 0.237, 95% CI 0.115-0.359). Neither the direct effect of ePWV on functional outcome nor the indirect effect through collateral status differed according to BP management strategy. CONCLUSION: Higher ePWV was associated with poor collateral status and unfavorable functional outcome after successful reperfusion. Collateral status accounted for only a small proportion of the observed association between ePWV and functional outcome.
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Han et al. (2026) conducted an observational in Acute ischemic stroke due to large vessel occlusion (n=285). Estimated pulse wave velocity (ePWV) vs. Lower estimated pulse wave velocity was evaluated on Poor functional outcome at 3 months (modified Rankin Scale score 3-6) (adjusted OR 1.338 per 1 m/s increase, 95% CI 1.121-1.597, p=0.001). Higher estimated pulse wave velocity was associated with a significantly increased risk of poor functional outcome at 3 months (adjusted OR 1.338 per 1 m/s increase) after successful endovascular thrombectomy.
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