Clinical correlates, procedural benchmarks, and reperfusion-outcome dissociation after mechanical…

ObservationalFrontiers in neurology· 2026

Clinical correlates, procedural benchmarks, and reperfusion-outcome dissociation after mechanical thrombectomy for acute large-vessel occlusion stroke: a single-center retrospective registry study.

Hao Xu, Zhouming Ren, Xinzheng Fu, Xuyan Zhang

NeuroendovascularObservationalQ2IF 3.1

Nearly half of successfully reperfused stroke patients failed to regain functional independence.

Clinical correlates, procedural benchmarks, and reperfusion-outcome dissociation after mechanical thrombectomy for acute large-vessel occlusion stroke: a single-center retrospective registry study.

Hao Xu … Xuyan Zhang

Frontiers in neurology · 2026 · Q2 in Neurology

Background

Endovascular thrombectomy (endovascular thrombectomy) is an established treatment for selected patients with acute ischemic stroke caused by large-vessel occlusion (large-vessel occlusion).

Methods

The final cohort included 212 patients; 90-day modified Rankin Scale (mRS) data were available in 206 (97.2%).

n = 212 patients

Results

nearly half of successfully reperfused patients still failed to regain functional independence

AOR by subgroup · 95% CI

More results

Baseline NIHSS score showed the most consistent adjusted association with lower odds of functional independence [Model 1: adjusted odds ratio (aOR) 0.95, 95% CI 0.91-0.99; Firth aOR 0.95, 95% CI 0.91-0.99].

More results

This magnitude is much larger than randomized-trial pooled estimates (relative risk approximately 1.05-1.15) and is best explained by confounding by indication.

The E-value of 2.10 for the point estimate (1.29 for the lower confidence bound) indicates that a moderately strong unmeasured confounder could explain the observed association.

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Conclusion · 1 of 2

In this single-center retrospective registry, baseline stroke severity was the most consistent clinical correlate of 90-day functional independence after mechanical thrombectomy, holding up across Firth-penalized, anterior-circulation-only, and collateral-adjusted sensitivity analyses.

Conclusion · 2 of 2

The intravenous thrombolysis association lost statistical significance under overlap weighting (aOR 1.88, 95% CI 0.58-6.09), which we read as confounded rather than causal and which brings the present registry in line with the small randomized-trial effect size.