ORIGINAL RESEARCH article
Front. Neurol.
Sec. Stroke
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1574948
This article is part of the Research TopicEvaluation of Fitness in Stroke SurvivorsView all 9 articles
Time dependency of thrombectomy for large artery atherosclerosis versus cardioembolic stroke subtypes: Evidence from the ANGEL-ACT registry
Provisionally accepted
Yue Yin
Hanlin Chen
Anxin Wang
Xiaoli ZhangMiao LiLigang Song
Baixue Jia
Ning Ma
Dapeng Mo
Xuan Sun
Feng Gao
Yiming Deng*
Zhongrong Miao*- Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Introduction: In this study, we investigated the differences in clinical outcomes following endovascular thrombectomy among ischemic stroke subtypes caused by large artery atherosclerosis (LAA) versus cardioembolism (CE) and the time-dependent nature of these clinical outcomes based on the stroke subtypes. Methods: Study participants were selected from the Endovascular Treatment Key Technique and Emergency Workflow Improvement of Acute Ischemic Stroke Registry to conduct a post-hoc analysis of a prospective, observational study. We included 1046 patients, who had either LAA or CE stroke subtypes based on the Trial of Org 10172 in Acute Stroke Treatment criteria, drawn from the thrombectomy cohort. The association between clinical outcomes and time from stroke onset-to-recanalization time (ORT) was analyzed using a logistic regression model.Results: Overall, 545 (52.6%) and 491 (47.4 %) patients were included in the LAA and CE groups, respectively. No significant difference was found in the 90-day clinical functional outcome between the LAA and CE patients when ORT was achieved within 240 min. Beyond 240 min, the rate of achieving a modified Rankin Scale score of 0-2 in patients with LAA was higher than that of patients with CE (48.17% versus 38.66%; odds ratio [OR]=0.678, 95% confidence interval [CI]=0.521-0.884, P = 0.0040), and after adjustment, the OR was 0.732 (95% CI: 0.537-0.998, P = 0.0486). Conclusion:In cases where the ORT exceeded 240 min, the clinical outcomes of patients with LAA were better than those of patients with CE, demonstrating a stronger time-dependency for achieving a favorable prognosis in patients with cardioembolic stroke.
Keywords: Thrombectomy, Time dependency, large artery atherosclerosis, cardioembolism, Stroke subtypes
Received: 11 Feb 2025; Accepted: 28 Apr 2025.
Copyright: © 2025 Yin, Chen, Wang, Zhang, Li, Song, Jia, Ma, Mo, Sun, Gao, Deng and Miao. 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:
Yiming Deng, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Zhongrong Miao, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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