Endovascular treatment versus best medical treatment for acute anterior cerebral artery occlusion: a single-center inverse probability of treatment-weighted cohort study.
- 1Department of Neurology, Wuhan No. 1 Hospital, Wuhan, Hubei, China.
Abstract
Introduction
Evidence regarding the benefit of endovascular treatment (EVT) for isolated acute anterior cerebral artery occlusion remains limited. We aimed to compare the efficacy and safety of EVT versus best medical treatment (BMT) in this population.Methods
We retrospectively screened consecutive patients with acute anterior cerebral artery occlusion between May 2020 and October 2025. The primary outcome was excellent functional outcome, defined as a 90-day modified Rankin Scale (mRS) score of 0-1. Secondary outcomes included 90-day mRS 0-2, mRS 0-3, mortality, symptomatic intracranial hemorrhage (sICH), and any intracranial hemorrhage (any ICH). Multivariable logistic regression and inverse probability of treatment weighting (IPTW) were used to adjust for baseline differences.Results
Among 69 included patients, 37 received BMT and 32 underwent EVT. Successful reperfusion was achieved in 27 of 32 patients treated with EVT (84.4%). The primary outcome of 90-day mRS 0-1 occurred in 17 of 37 patients (45.9%) in the BMT group and 13 of 32 patients (40.6%) in the EVT group. EVT was not significantly associated with 90-day mRS 0-1 after adjustment (adjusted odds ratio [OR], 1.74; 95% confidence interval [CI], 0.50-5.99). No significant differences were observed for 90-day mRS 0-2, mRS 0-3, mortality, sICH, or any ICH. IPTW-adjusted sensitivity analyses yielded consistent results.Conclusion
EVT showed high reperfusion success but was not associated with a statistically significant improvement in 90-day functional outcomes compared with BMT. Further multicenter studies are needed to clarify the potential role of EVT in this population.
Related
- Early postoperative ipsilateral middle cerebral artery pulsatility index is associated with cerebral hemorrhage after endovascular treatment in anterior circulation large vessel occlusion
- Cause-specific mortality after endovascular treatment for anterior vs. posterior circulation large vessel occlusion: a multicenter cohort study
- Early neurological deterioration after endovascular treatment in acute ischemic stroke with large vessel occlusion.
- Efficacy of balloon guide catheter in endovascular treatment according to occlusion location
- Association of endovascular treatment versus intravenous thrombolysis in mild stroke across occlusion subgroups
BibTeX
@article{wan2026endovascular,
title = {{Endovascular treatment versus best medical treatment for acute anterior cerebral artery occlusion: a single-center inverse probability of treatment-weighted cohort study.}},
author = {Xiaolin Wan and Baoming Lei and Kun Tang and Haifeng Liu and Yi Yang and Wenhua Liu and Zhangbao Guo},
journal = {Frontiers in neurology},
year = {2026},
month = oct,
doi = {10.3389/fneur.2026.1896249},
url = {https://europepmc.org/article/MED/42908847},
note = {CC BY},
}
RIS
TY - JOUR
TI - Endovascular treatment versus best medical treatment for acute anterior cerebral artery occlusion: a single-center inverse probability of treatment-weighted cohort study.
AU - Xiaolin Wan
AU - Baoming Lei
AU - Kun Tang
AU - Haifeng Liu
AU - Yi Yang
AU - Wenhua Liu
AU - Zhangbao Guo
PY - 2026
DA - 2026/10/07
JO - Frontiers in neurology
DO - 10.3389/fneur.2026.1896249
UR - https://europepmc.org/article/MED/42908847
AB - Introduction Evidence regarding the benefit of endovascular treatment (EVT) for isolated acute anterior cerebral artery occlusion remains limited. We aimed to compare the efficacy and safety of EVT versus best medical treatment (BMT) in this population.Methods We retrospectively screened consecutive patients with acute anterior cerebral artery occlusion between May 2020 and October 2025. The primary outcome was excellent functional outcome, defined as a 90-day modified Rankin Scale (mRS) score of 0-1. Secondary outcomes included 90-day mRS 0-2, mRS 0-3, mortality, symptomatic intracranial hemorrhage (sICH), and any intracranial hemorrhage (any ICH). Multivariable logistic regression and inverse probability of treatment weighting (IPTW) were used to adjust for baseline differences.Results Among 69 included patients, 37 received BMT and 32 underwent EVT. Successful reperfusion was achieved in 27 of 32 patients treated with EVT (84.4%). The primary outcome of 90-day mRS 0-1 occurred in 17 of 37 patients (45.9%) in the BMT group and 13 of 32 patients (40.6%) in the EVT group. EVT was not significantly associated with 90-day mRS 0-1 after adjustment (adjusted odds ratio [OR], 1.74; 95% confidence interval [CI], 0.50-5.99). No significant differences were observed for 90-day mRS 0-2, mRS 0-3, mortality, sICH, or any ICH. IPTW-adjusted sensitivity analyses yielded consistent results.Conclusion EVT showed high reperfusion success but was not associated with a statistically significant improvement in 90-day functional outcomes compared with BMT. Further multicenter studies are needed to clarify the potential role of EVT in this population.
SN - 1664-2295
ER -