Unsuccessful reperfusion tied to early unfavorable outcomes after thrombectomy for low NIHSS stroke

In a Canadian registry of 439 stroke patients with low NIHSS (≤5) undergoing endovascular thrombectomy, 11% had early unfavorable outcomes; unsuccessful reperfusion (TICI <2b) was the strongest modifiable factor (adjusted odds ratio 41.52, 95% CI 5.31–324.62).

• Retrospective case-control analysis of the Canadian OPTIMISE registry included 439 low NIHSS (≤5) large vessel occlusion stroke patients treated with endovascular thrombectomy; 50 cases were matched 4:1 to 200 controls by age, sex, and baseline NIHSS.
• The primary endpoint was a composite of 24-hour neurological worsening (NIHSS increase ≥4), symptomatic intracranial hemorrhage, in-hospital death, or discharge to long-term care.
• Unsuccessful reperfusion (TICI <2b) was the only modifiable factor significantly associated with early unfavorable outcomes; prior IV thrombolysis, thrombectomy technique, and procedural complications were not associated.

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