Prognostic factors of endovascular treatment in acute ischemic stroke following primary anterior-circulation distal medium vessel occlusion

To investigate prognostic factors in endovascular treatment (EVT)-treated patients with acute ischemic stroke (AIS) due to primary anterior-circulation distal medium vessel occlusion (DMVO). This study included 213 AIS patients with primary anterior-circulation DMVO post-EVT from the pooled DEVT, RESCUE BT, and SUSTAIN multicenter studies. Favorable functional outcome was categorized as the modified Rankin Scale (mRS) score at 90 days of 0–2; unfavorable functional outcome was categorized as mRS score of 3–6. Multivariable logistic regression was used to identify factors associated with 90-day outcomes among EVT-treated patients. Favorable functional outcome (mRS score 0–2), mortality and symptomatic intracranial hemorrhage (sICH) were 53.1%, 12.2%, and 13.1%, respectively. Patients with favorable functional outcomes had a younger age ( P < 0.001), a lower baseline NIHSS ( P < 0.001), better collateral status ( P = 0.048). A favorable functional outcome was significantly associated with a younger age ( aOR, 0.96; 95% CI, 0.93–0.99; P = 0.005) and a lower baseline NIHSS score (aOR, 0.89; 95% CI, 0.84–0.95; P < 0.001). Older age (aOR, 1.05; 95% CI, 1.01–1.10), higher baseline NIHSS score (aOR, 1.11; 95% CI, 1.03–1.22), and longer procedure time (aOR, 1.01; 95% CI, 1.002–1.018) were independently associated with 90-day mortality (all P < 0.05). This study identifies factors associated with favorable functional outcome and mortality after EVT for primary anterior-circulation DMVO. While younger age and lower baseline NIHSS score were associated with favorable functional outcomes, older age, higher baseline NIHSS score and longer procedure time were associated with predicted mortality. Not applicable.