ORIGINAL RESEARCH article
Front. Neurol.
Sec. Endovascular and Interventional Neurology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1543743
Factors associated with Delayed Neurologic Improvement after Complete Endovascular Reperfusion in Anterior and Posterior Ischemic Stroke
Provisionally accepted
- 1Uijeongbu Eulji Medical Center, Eulji University, Gyeonggi, Republic of Korea
- 2Department of Radiology, Asan Medical Center, Seoul, Republic of Korea
- 3Department of Neurology, Asan Medical Center, Seoul, Republic of Korea
- 4Department of Neurology, Gil Medical Center, Incheon, Republic of Korea
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Background: Mechanisms underlying delayed neurological improvement (DNI) after endovascular thrombectomy (EVT) in patients with anterior (ACS) and posterior circulation stroke (PCS) may differ. This study aims to compare the factors associated with DNI in patients with ACS and PCS.Materials and Methods: Data of patients who underwent EVT with National Institute of Health Stroke Scale (NIHSS) score more than 6 and achieved successful reperfusion were retrospectively analyzed. DNI was defined as achieving favorable functional outcomes at 90 days, even without early neurological improvement. The factors associated with DNI in patients with ACS and PCS were investigated.Results: A total of 241 patients were included. The proportions of DNI (30.8% vs. 20.0%; P=0.184) were not significantly different between patients with ACS and PCS. In patients with ACS, absence of atrial fibrillation (aOR = 0.500; 95% CI, 0.264–0.945; P = 0.033), statin use (aOR = 2.842; 95% CI, 1.174–6.882; P = 0.021), lower NIHSS score after 24 hours (aOR = 0.816; 95% CI 0.757–0.880; P <0.001), and shorter onset-to-door time (aOR = 0.999; 95% CI, 0.998–1.000; P = 0.025) were significantly associated with DNI. In patients with PCS, male sex (aOR = 31.809; 95% CI, 1.816–557.074; P = 0.018) and lower initial NIHSS scores (aOR = 0.626; 95% CI, 0.410–0.957; P = 0.031) were significantly associated with DNI.Conclusions: The proportions of DNI were similar in patients with ACS and PCS. However, the factors associated with DNI were different between the two groups.
Keywords: Endovascular thrombectomy, Early neurological improvement, Delayed neurological improvement, Anterior circulation stroke, Posterior circulation stroke
Received: 11 Dec 2024; Accepted: 13 May 2025.
Copyright: © 2025 Park, Kwon, Chang, Song, LEE, Ha and Kim. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Sang Hee Ha, Department of Neurology, Gil Medical Center, Incheon, Republic of Korea
Bum Joon Kim, Department of Neurology, Asan Medical Center, Seoul, Republic of Korea
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