Key result
Higher admission NIHSS is linked to ~24% lower odds of favorable stroke recovery after thromboaspiration.
Why the study?
The study aimed to determine the functional and angiographic outcomes of mechanical thrombectomy by direct thromboaspiration in patients with acute ischemic large vessel occlusion stroke at a single center.
Does mechanical thrombectomy by direct thromboaspiration improve functional and angiographic outcomes at 30 days in patients with acute ischemic large vessel occlusion stroke?
Cohort (n=98)
No
Does mechanical thrombectomy by direct thromboaspiration improve functional and angiographic outcomes at 30 days in patients with acute ischemic large vessel occlusion stroke?
Direct thromboaspiration for acute ischemic large vessel occlusion stroke in a South Asian center achieved a 78.6% recanalization rate and 41.8% good functional outcome at 30 days, with baseline NIHSS score serving as the sole independent predictor of functional recovery.
Answers are grounded in this paper and cite their sources.
Direct aspiration thrombectomy yields feasible outcomes in LVO; hypothesis-generating and should not yet change practice.
Objective: To determine the Functional outcomes of Mechanical Thrombectomy (MT) by direct thromboaspiration in acute ischemic Large Vessel Occlusion (LVO) stroke. Methodology: Patients who received MT for acute ischemic LVO stroke from January 2024 to February 2026 were included in this retrospective observational cohort study, which was carried out in the Department of Neuro Endovascular Surgery at Punjab Institute of Neurosciences, Lahore, Pakistan. The Statistical Package for the Social Sciences (SPSS), version 29, was used to analyze the data. The mean National Institutes of Health Stroke Scale (NIHSS) score before and after the procedure was compared using the Wilcoxon signed-rank test following the computation of descriptive statistics. In acute ischemic LVO stroke, binary logistic regression analysis was used to find variables that independently predicted favorable functional outcomes following MT. Results: Of the total 98 patients, the mean age was 55.53±13.26 years with male predominance of 67.30% (66). On admission, the mean NIHSS score was 15.95±4.87. Intravenous tissue plasminogen activator (tPA) was given in 41.80% (41) cases. After the procedure, a significant reduction in mean NIHSS score was observed by the Wilcoxon signed-rank test, i.e., z=-8.136, p < 0.001. The post-procedural good functional outcomes (Modified Rankin Score [mRS]≤2) were observed in 41.8% (41) patients at 30 days. Almost 20% of patients had post-procedural asymptomatic intracranial hemorrhage (ICH), including reperfusion injuries (3%), with a 30-day stroke-related mortality rate of 15%. Admission-NIHSS (p<0.001) was the only independent predictor of favorable mRS after MT for acute ischemic LVO stroke, i.e., Odds Ratio (OR): 0.76, 95% Confidence Interval (CI): 0.676-0.866, p<0.001. Conclusion: MT in acute ischemic LVO stroke results in successful recanalization and good functional outcomes. Mean NIHSS score is a significant baseline prognostic factor that determines the outcomes of patients after MT.
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Ijaz et al. (2026) conducted a cohort in Acute ischemic Large Vessel Occlusion (LVO) stroke (n=98). Direct aspiration mechanical thrombectomy (ADAPT) and baseline NIHSS score was evaluated on Favorable functional outcome (Modified Rankin Score [mRS] <=2) at 30 days predicted by admission NIHSS score (OR 0.765, 95% CI 0.676-0.866, p=<0.001). Direct thromboaspiration achieved 41.8% 30-day good functional outcomes (mRS <=2) and 78.6% recanalization, with admission NIHSS independently predicting favorable mRS (OR 0.765, p<0.001).
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