Journal article
Impact of reperfusion on thrombectomy outcomes in patients with pre-stroke disability
Frontiers in neurology, Vol.17, 1821598
07/01/2026
DOI: 10.3389/fneur.2026.1821598
PMCID: PMC13368995
PMID: 42459851
Abstract
Background: Mechanical thrombectomy (MT) is frequently performed beyond traditional eligibility criteria, yet the clinical benefits for patients with pre-stroke disability remain uncertain.Methods: We conducted a retrospective multicenter cohort study of patients undergoing MT for anterior circulation large-vessel occlusion stroke across a spectrum of baseline disability (modified Rankin Scale [mRS] 0–4). The primary analysis evaluated the impact of reperfusion success and the 90-day mRS shift within each baseline mRS stratum using ordinal logistic regression adjusted for age, NIHSS, ASPECTS, and occlusion site. Secondary analyses assessed discharge mRS, the effect of first-pass effect (FPE), and whether the etiology of pre-stroke disability modified outcomes.Results: Among 4,840 MT patients, 1,457 (30.1%) had pre-stroke disability (mRS 1–4), with considerable variation in selection practices across centers. In adjusted models, successful reperfusion showed significantly greater odds of improved 90-day mRS for patients with baseline mRS 0–3, with a similar directional benefit in those with mRS 4. No significant interaction between reperfusion and baseline disability regards 90-day mRS was detected (p = 0.12). Successful reperfusion was also associated with lower discharge mRS across all baseline strata. FPE yielded consistent clinical benefit irrespective of pre-stroke disability level. Outcomes were comparable between patients with neurological versus non-neurological sources of disability.Conclusion: Successful reperfusion was linked to improved functional outcomes across a wide range of pre-stroke disability levels. Disability etiology did not significantly modify treatment benefits. These findings may support considering MT to appropriately selected patients with baseline disability. Further studies are warranted.
Details
- Title: Subtitle
- Impact of reperfusion on thrombectomy outcomes in patients with pre-stroke disability
- Creators
- Sávio Batista - Grady Memorial HospitalJaydevsinh N. Dolia - Emory UniversityJonathan Grossberg - Emory UniversityRaul Nogueira - UPMC Health SystemSantiago Ortega-Gutierrez - University of IowaSunil Sheth - The University of Texas Health Science Center at HoustonAlex Alqudah - Grady Memorial HospitalTheja Yelam - Grady Memorial HospitalPedro Nascimento Martins - Emory UniversityAlhamza R. Al-Bayati - UPMC Health SystemMohamed F. Doheim - UPMC Health SystemLucas Rios Rocha - University of Pittsburgh Medical CenterJorge Cespedes - University of Iowa Hospitals and ClinicsLeonardo Cruz-Criollo - University of IowaAnderson Brito - University of IowaNgoc Mai Le - The University of Texas Health Science Center at HoustonHussain M Azeem - The University of Texas Health Science Center at HoustonJoseph N Samaha - The University of Texas Health Science Center at HoustonDiogo C. Haussen - Grady Memorial Hospital
- Resource Type
- Journal article
- Publication Details
- Frontiers in neurology, Vol.17, 1821598
- DOI
- 10.3389/fneur.2026.1821598
- PMID
- 42459851
- PMCID
- PMC13368995
- NLM abbreviation
- Front Neurol
- ISSN
- 1664-2295
- eISSN
- 1664-2295
- Publisher
- Frontiers Media; LAUSANNE
- Language
- English
- Date published
- 07/01/2026
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9985180788202771
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