{
  "abstract": "Background Endovascular therapy (EVT) is standard treatment for large vessel occlusion in patients with a National Institutes of Health Stroke Scale (NIHSS) score ≥6, but its role in mild stroke (NIHSS score <6) remains uncertain.Objective To explore the association between EVT and clinical outcomes in mild stroke.Methods This study prospectively enrolled consecutive patients with a mild stroke at 35 comprehensive stroke centers in China between January 2020 and December 2023. Patients were categorized into primary EVT (pEVT) or best medical management (BMM) groups. The primary outcome was an excellent outcome (modified Rankin Scale (mRS) score ≤1). Secondary outcomes included a good outcome (mRS score ≤2) and lowering of the mRS score. Safety endpoints were mortality and symptomatic intracranial hemorrhage. Outcomes were compared between groups using multivariable logistic regression and inverse probability of treatment weighting (IPTW).Results Finally, 307 patients were included: 117 received pEVT, and 190 received BMM. In the IPTW model, pEVT was associated with higher excellent (aOR=3.6, 95% CI 2.5 to 5.2) and good (aOR=4.0, 95% CI 2.5 to 6.6) outcomes, lower mortality (aOR=0.1, 95% CI 0.01 to 0.4), and a lower 90-day mRS (aOR=0.2, 95% CI 0.1 to 0.3), with similar sICH rates. Among the BMM group, 80 patients (42.1%) experienced early neurological deterioration (END), with 55 receiving rescue EVT (rEVT), and were still included in BMM group. In the multivariable model, the rEVT was related with higher excellent (aOR=7.2, 95% CI 1.4 to 37.9) and good (aOR=4.1, 95% CI 1.2 to 14.8) outcomes and a lower mRS (aOR=2.0, 95% CI 0.9 to 4.8).Conclusions Primary EVT significantly increases the likelihood of achieving an excellent outcome in mild stroke. Over 40% of patients with a mild stroke treated with BMM experienced END, and rEVT effectively improved the prognosis.",
  "authors": [
    {
      "affiliations": [
        "Neurology Department, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China",
        "Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Beijing, China"
      ],
      "name": "Tingyu Yi"
    },
    {
      "affiliations": [
        "Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China"
      ],
      "name": "Shujuan Gan"
    },
    {
      "affiliations": [
        "Neurology Department, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China"
      ],
      "name": "Mei-hua Wu"
    },
    {
      "affiliations": [
        "Neurology Department, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China"
      ],
      "name": "Weifeng Huang"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Beijing, China"
      ],
      "name": "Dapeng Sun"
    },
    {
      "affiliations": [
        "Neurology Department, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China"
      ],
      "name": "Yuehong He"
    },
    {
      "affiliations": [
        "Neurology Department, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China"
      ],
      "name": "Yan-min Wu"
    },
    {
      "affiliations": [
        "Neurology Department, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China"
      ],
      "name": "Ding-lai Lin"
    },
    {
      "affiliations": [
        "Neurology Department, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China"
      ],
      "name": "Xiao-hui Lin"
    },
    {
      "affiliations": [
        "Neurology Department, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China"
      ],
      "name": "Zhi-nan Pan"
    },
    {
      "affiliations": [
        "Neurology Department, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China"
      ],
      "name": "Yi-ning Yang"
    },
    {
      "affiliations": [
        "Neurology Department, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China"
      ],
      "name": "Jin-hua Ye"
    },
    {
      "affiliations": [
        "Neurology Department, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China"
      ],
      "name": "Cai-Xia Li"
    },
    {
      "affiliations": [
        "Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China"
      ],
      "name": "Zhiting Chen"
    },
    {
      "affiliations": [
        "Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China"
      ],
      "name": "Ming-Zhu Huang"
    },
    {
      "affiliations": [
        "Neurology Department, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China"
      ],
      "name": "Xiu-fen Zheng"
    },
    {
      "affiliations": [
        "Department of Emergency, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China"
      ],
      "name": "Xiao-Bin Li"
    },
    {
      "affiliations": [
        "Department of Neurology, Fushun Central Hospital, Fushun, Liaoning, China"
      ],
      "name": "Fenglong Lang"
    },
    {
      "affiliations": [
        "Department of Neurology, Wuhan University People’s Hospital Affiliated, Wuhan, Hubei, China"
      ],
      "name": "Qian Tan"
    },
    {
      "affiliations": [
        "Department of Neurology, Luannan County Hospital, Tangshan, Hebei, China"
      ],
      "name": "Xiao-Jun Jin"
    },
    {
      "affiliations": [
        "Department of Neurology, Shaowu Municipal Hospital, Shaowu, Fujian, China"
      ],
      "name": "Jian-Qiu Fu"
    },
    {
      "affiliations": [
        "Department of Neurology, Binzhou People’s Hospital, Binzhou, Shandong, China"
      ],
      "name": "Fu-Qiang Fan"
    },
    {
      "affiliations": [
        "Department of Neurology, The Second Affiliated Hospital to Xiamen Medical College, Xiamen, Fujian, China"
      ],
      "name": "Na Xu"
    },
    {
      "affiliations": [
        "Department of Neurology, Gansu Province Medical Information Institute, Lanzhou, Gansu, China"
      ],
      "name": "Ya Shao"
    },
    {
      "affiliations": [
        "Department of Neurology, Shenyang First People’s Hospital, Shenyang, Liaoning, China"
      ],
      "name": "Yi Sui"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Beijing, China"
      ],
      "name": "Zhongrong Miao"
    },
    {
      "affiliations": [
        "Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China"
      ],
      "name": "Wen-huo Chen"
    }
  ],
  "title": "Medical and endovascular treatment for acute large vessel occlusion with mild stroke: a real-world nationwide registry",
  "uid": "5001c432-425c-5db6-b2db-a0880b463275"
}