ORIGINAL RESEARCH article
Front. Neurol.
Sec. Stroke
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1671672
This article is part of the Research TopicPost-stroke Epilepsy: Risks, Prognosis, and PreventionView all 5 articles
Predictors of Functional Deterioration from 90 Days to 1 Year After Endovascular Treatment for Vertebrobasilar Artery Occlusion: A Multicenter Retrospective Study
Provisionally accepted
- 1Xuzhou Central Hospital, Xuzhou, China
- 2The First Affiliated Hospital of USTC Hefei Ion Medical Center, Hefei, China
- 3Xuzhou Medical University, Xuzhou, China
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Objective: To investigate risk factors for delayed neurological deterioration (1-year mRS score > 90-day score) in patients with acute ischemic stroke due to vertebrobasilar artery occlusion (VBAO) after endovascular treatment (EVT), and to evaluate heterogeneity across age and sex subgroups. Methods: This multicenter retrospective study included 1342 VBAO patients who underwent EVT between December 2015 and June 2022. Based on dynamic changes in the mRS score, patients were categorized into a 1-year functional deterioration group (n=288) and a functional stability group (n=1054). Multivariate binary logistic regression was used to identify factors associated with long-term functional deterioration. Stratified analyses were further performed by age (≤70 years vs. >70 years) and sex. Results: After adjusting for demographics and clinical variables, the following factors were independently associated with 1-year functional deterioration (all P<0.05): female sex (OR=1.425, 95%CI:1.062-1.911), increasing age (per year) (OR=1.016, 95%CI: 1.004-1.028), Door-to-Puncture Time (DTP) (OR=1.001, 95%CI: 1.000-1.001), modified Thrombolysis in Cerebral Infarction (mTICI) score (2b, OR=0.452, 95%CI: 0.234-0.874; 3, OR=0.398, 95%CI: 0.213-0.742) and number of attempts( ≥4, OR=3.765, 95%CI: 1.601-8.854). Gender-stratified analysis shows age and DTP drive female outcomes; male outcomes are regulated by complex surgical factors. Age stratification reveals younger females have poorer improvement than males with equal reperfusion, while in older patients, operation count strongly impacts outcomes, with high-quality reperfusion buffering multiple operations' harm. Conclusion: This study revealed that the functional outcomes of patients with VBAO from 90 days to 1 year after EVT exhibit distinct patterns, with the dominant influencing factors varying by gender and age group. This provides an important basis for the formulation of individualized treatment strategies.
Keywords: Stroke, Vertebrobasilar artery occlusion, endovascular treatment, Long-term prognosis, Risk factors
Received: 23 Jul 2025; Accepted: 21 Oct 2025.
Copyright: © 2025 Wang, Wen, Ping, Chen, Fu, Liu, Li and Yao. 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: Meixue Yao, yaomeixue@163.com
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