LAUSR

BACKGROUND To identify baseline clinical and radiological/procedural predictors and 24-hour radiological predictors for clinical and functional outcomes in stroke patients obtaining complete recanalization in one pass of mechanical thrombectomy (MT) in an optimal baseline and procedural setting. METHODS We conducted a retrospective analysis of prospectively collected data from 924 stroke patients with anterior LVO, ASPECTS ≥6, and pre-stroke mRS =0, who started MT ≤6 hours from symptom onset and obtained first-pass complete recanalization. We performed a first logistic regression model to identify baseline clinical predictors and a second model to identify baseline radiological/procedural predictors. We performed a third model including baseline clinical and radiological/procedural predictors, and a fourth model including independent baseline predictors from the third model plus 24-hour radiological variables (hemorrhagic transformation, HT and cerebral edema, CED). RESULTS In the fourth model, higher NIHSS score (OR:1.089) and higher ASPECTS (OR:1.292) were predictors of early neurological improvement (ENI, NIHSS score ≤4 points from baseline or NIHSS score of 0 at 24 hours), whereas older age (OR:0.973), longer procedure time (OR:0.990), HT (OR:0.272), and CED (OR:0.569) were inversely associated with ENI. Older age (OR:0.970), diabetes mellitus (OR:0.456), higher NIHSS score (OR:0.886), general anesthesia (OR:0.454), longer onset-to-groin time (OR:0.996), HT (OR:0.340), and CED (OR:0.361) were inversely associated with 3-month excellent functional outcome (mRS score 0-1), whereas higher ASPECTS (OR:1.294) was predictor of excellent outcome. CONCLUSIONS Higher NIHSS score was predictor of ENI, but inversely associated with 3-month excellent outcome. Older age, HT, and CED were inversely associated with both good outcomes.