Sex-Related Differences in Outcomes of Endovascular Treatment of Distal Medium Vessel Occlusion Strokes.

IF 2.6 3区医学 Q2 Medicine

Clinical Neuroradiology Pub Date : 2026-03-10 DOI:10.1007/s00062-026-01632-w

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 Kühn, 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, João Pedro Filipe, Pablo Harker, Răzvan Alexandru Radu, Mohamad Abdalkader, Piers Klein, Takahiro Ota, Ashkan Mowla, Kareem El Naamani, Pascal Jabbour, Arundhati Biswas, Frédéric Clarençon, James E Siegler, Thanh N Nguyen, Ricardo Varela, Amanda Baker, David Altschul, Nestor R Gonzalez, Markus A Möhlenbruch, 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

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引用次数: 0

Abstract

Background: Sex-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.

Methods: We 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.

Results: Before 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).

Conclusions: After 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.

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远端中血管闭塞性卒中血管内治疗结果的性别差异。

背景：机械取栓（MT）治疗远端中血管闭塞（DMVO）卒中后预后的性别差异尚不确定。虽然在中风人群中有未调整的差异报道，但在考虑主要预后因素后，尚不清楚生理性别是否独立影响结果。方法：我们对MAD-MT登记进行了回顾性的多中心分析。急性DMVO患者接受MT。采用倾向得分匹配（PSM）。90天的主要终点是功能独立性（修正Rankin量表[mRS]评分0-2）。次要结局包括良好结局（mRS 0-1）、第1天NIHSS转移和再灌注成功。安全性结果包括死亡率和症状性脑出血。结果：配对前共纳入女性1147人，男性1062人。1:1 PSM（每组748例患者）后，各组基线特征平衡。两组患者的中位年龄均为75岁。在第90天，51%的雌性和54%的雄性达到mRS 0-2 （P = 0.38）。NIHSS从基线到第1天的变化相似（两组的中位数为-2），86%的女性和89%的男性实现了成功的再灌注（脑梗死2b-3溶栓）（P = 0.18）。死亡率女性为18.4%，男性为15.5% （P = 0.11）。出现症状性脑出血的女性为8.3%，男性为7.7% （P = 0.67）。结论：在调整了年龄、基线残疾和血管危险因素后，生理性别与DMVO卒中机械取栓后的功能或安全性结果没有独立关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neuroradiology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

4.90

自引率

3.60%

发文量

期刊介绍： Clinical Neuroradiology provides current information, original contributions, and reviews in the field of neuroradiology. An interdisciplinary approach is accomplished by diagnostic and therapeutic contributions related to associated subjects. The international coverage and relevance of the journal is underlined by its being the official journal of the German, Swiss, and Austrian Societies of Neuroradiology.