Early neurological deterioration after endovascular treatment in acute ischemic stroke with large vessel occlusion.
8 affiliations
- 1Department of Neurology, Shanxi Key Laboratory of Brain Disease Control, Shanxi Provincial People's Hospital, Taiyuan, China.
- 2Department of Neuroscience, Dharmais Cancer Hospital - National Cancer Center, Jakarta, Indonesia.
- 3Clinical Research Unit, Dharmais Cancer Hospital - National Cancer Center, Jakarta, Indonesia.
- 4Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, No.119, the South Fourth Ring West Road, Fengtai District, Beijing, 100050, China.
- 5Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
- 6National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
- 7Department of Neurology, Shanxi Key Laboratory of Brain Disease Control, Shanxi Provincial People's Hospital, Taiyuan, China. [email protected].
- 8Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, No.119, the South Fourth Ring West Road, Fengtai District, Beijing, 100050, China. [email protected].
Abstract
Purpose
This study aimed to explore the occurrence, identify independent predictors, and assess the clinical implications of END following EVT in individuals with acute LVO.Methods
Participants were enrolled from the ANGEL-ACT registry. END was characterized by a rise of ≥ 4 points in the National Institutes of Health Stroke Scale (NIHSS) score from baseline to 24 h post-EVT. We conducted logistic regression analyses to pinpoint independent predictors of END.Results
Among the 1557 patients included in the study, the occurrence of END stood at 9.8%. Factors independently associated with END included an admission NIHSS (adjusted odds ratio (aOR) = 4.067, 95% CI 2.513 to 6.582, p < 0.0001), an admission neutrophil-to-lymphocyte ratio (NLR) exceeding 5 (aOR = 1.811, 95% CI 1.246 to 2.632, p = 0.0018), the use of general anesthesia (GA) (aOR = 0.474, 95% CI 0.330 to 0.682, p < 0.0001), longer procedure duration (aOR = 5.500, 95% CI 1.45 to 20.871, p = 0.0122), and more than three retrieval attempts (aOR = 1.294, 95% CI 1.177 to 1.422, p < 0.0001).Conclusions
END manifested in 9.8% of patients undergoing endovascular therapy (EVT) for acute large vessel occlusion (LVO). This investigation highlights various independent predictors of END, providing valuable insights for daily clinical practice aimed at enhancing the effectiveness of intravascular thrombectomy.Registration
URL: https://www.Clinicaltrials
gov ; Unique identifier: NCT03370939; registration date: 11th November 2017.
Related
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- Correlation of TyG and NLR with early neurological deterioration after thrombolysis in patients with acute ischemic stroke
- Vessel wall MRI predictors of postprocedural new ischemic brain lesions after endovascular treatment for basilar artery stenosis
BibTeX
@article{han2026early,
title = {{Early neurological deterioration after endovascular treatment in acute ischemic stroke with large vessel occlusion.}},
author = {Bin Han and Raynald and Muhammad Firdaus and Dapeng Sun and Yaxin Wu and XuTong and Baixue Jia and Anxin Wang and Dapeng Mo and Feng Gao and Ning Ma and Yaxuan Sun and Zhongrong Miao},
journal = {BMC neurology},
year = {2026},
month = jul,
doi = {10.1186/s12883-026-05150-7},
url = {https://europepmc.org/article/MED/42928143},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Early neurological deterioration after endovascular treatment in acute ischemic stroke with large vessel occlusion.
AU - Bin Han
AU - Raynald
AU - Muhammad Firdaus
AU - Dapeng Sun
AU - Yaxin Wu
AU - XuTong
AU - Baixue Jia
AU - Anxin Wang
AU - Dapeng Mo
AU - Feng Gao
AU - Ning Ma
AU - Yaxuan Sun
AU - Zhongrong Miao
PY - 2026
DA - 2026/07/29
JO - BMC neurology
DO - 10.1186/s12883-026-05150-7
UR - https://europepmc.org/article/MED/42928143
AB - Purpose This study aimed to explore the occurrence, identify independent predictors, and assess the clinical implications of END following EVT in individuals with acute LVO.Methods Participants were enrolled from the ANGEL-ACT registry. END was characterized by a rise of ≥ 4 points in the National Institutes of Health Stroke Scale (NIHSS) score from baseline to 24 h post-EVT. We conducted logistic regression analyses to pinpoint independent predictors of END.Results Among the 1557 patients included in the study, the occurrence of END stood at 9.8%. Factors independently associated with END included an admission NIHSS (adjusted odds ratio (aOR) = 4.067, 95% CI 2.513 to 6.582, p < 0.0001), an admission neutrophil-to-lymphocyte ratio (NLR) exceeding 5 (aOR = 1.811, 95% CI 1.246 to 2.632, p = 0.0018), the use of general anesthesia (GA) (aOR = 0.474, 95% CI 0.330 to 0.682, p < 0.0001), longer procedure duration (aOR = 5.500, 95% CI 1.45 to 20.871, p = 0.0122), and more than three retrieval attempts (aOR = 1.294, 95% CI 1.177 to 1.422, p < 0.0001).Conclusions END manifested in 9.8% of patients undergoing endovascular therapy (EVT) for acute large vessel occlusion (LVO). This investigation highlights various independent predictors of END, providing valuable insights for daily clinical practice aimed at enhancing the effectiveness of intravascular thrombectomy.Registration URL: https://www.Clinicaltrials gov ; Unique identifier: NCT03370939; registration date: 11th November 2017.
SN - 1471-2377
ER -