Research & Innovation
Publications
Sex-Related Differences in Outcomes of Endovascular Treatment of Distal Medium Vessel Occlusion Strokes
PMU Authors
Constantin Hecker, Christoph J. Griessenauer
All Authors
Hamza Adel Salim, Vivek Yedavalli, Dhairya Lakhani, Fathi Milhem, Basel Musmar, Nimer Adeeb, Davide Simonato, Yan-Lin Li, Orabi Hajjeh, Muhammed Amir Essibayi, Nils Henninger, Sri Hari Sundararajan, Anna Luisa Kuhn, Jane Khalife, Sherief Ghozy, Luca Scarcia, Leonard Ll. Yeo, Benjamin Yq Tan, Robert W. Regenhardt, Jeremy J. Heit, Aymeric Rouchaud, Jens Fiehler, Sunil Sheth, Ajit S. Puri, Christian Dyzmann, Marco Colasurdo, Leonardo Renieri, Joao Pedro Filipe, Pablo Harker, Razvan Alexandru Radu, Mohamad Abdalkader, Piers Klein, Takahiro Ota, Ashkan Mowla, Kareem El Naamani, Pascal Jabbour, Arundhati Biswas, Frederic Clarencon, James E. Siegler, Thanh N. Nguyen, Ricardo Varela, Amanda Baker, David Altschul, Nestor R. Gonzalez, Markus A. Mohlenbruch, Vincent Costalat, Benjamin Gory, Christian Paul Stracke, Constantin Hecker, Gaultier Marnat, Hamza Shaikh, Christoph J. Griessenauer, David S. Liebeskind, Alessandro Pedicelli, Andrea M. Alexandre, Tobias D. Faizy, Illario Tancredi, Erwah Kalsoum, Boris Lubicz, Aman B. Patel, Maurizio Fuschi, Max Wintermark, Adrien Guenego, Adam A. Dmytriw
Journal association
CLINICAL NEURORADIOLOGY
Abstract
BackgroundSex-related differences in outcomes after mechanical thrombectomy (MT) for distal medium vessel occlusion (DMVO) stroke remain uncertain. While unadjusted differences have been reported in stroke populations, it is unclear whether biological sex independently influences outcomes after accounting for major prognostic factors.MethodsWe performed a retrospective, multicenter analysis of the MAD-MT registry. Patients with acute DMVO who underwent MT were included. Propensity score matching (PSM) was employed. The primary outcome was functional independence (modified Rankin Scale [mRS] score 0-2) at 90 days. Secondary outcomes included excellent outcome (mRS 0-1), day 1 NIHSS shift, and reperfusion success. Safety outcomes included mortality and symptomatic intracerebral hemorrhage.ResultsBefore matching, 1147 females and 1062 males were included. After 1:1 PSM (748 patients in each group), the groups were balanced in baseline characteristics. The median age was 75 years in both groups. At 90 days, 51% of females and 54% of males achieved mRS 0-2 (P = 0.38). NIHSS shift from baseline to day 1 was similar (median -2 in both groups), and successful reperfusion (Thrombolysis in Cerebral Infarction 2b-3) was achieved in 86% of females and 89% of males (P = 0.18). Mortality was 18.4% in females and 15.5% in males (P = 0.11). Symptomatic intracerebral hemorrhage occurred in 8.3% of females and 7.7% of males (P = 0.67).ConclusionsAfter adjustment for age, baseline disability, and vascular risk factors, biological sex was not independently associated with functional or safety outcomes following mechanical thrombectomy for DMVO stroke.
Keywords
ENDOVASCULAR TREATMENT, STROKE, MECHANICAL THROMBECTOMY, Sex differences, Functional outcome, Neurointervention, Ischemic stroke, Distal Medium Vessel Occlusion, Multicenter Study, Propensity Score Matching