Cerebrovascular Diseases最新文献

{"title":"The Impact of Abnormal Distribution of Abdominal Adiposity and Skeletal Muscle on the Prognosis of Ischemic Stroke.","authors":"Chengcheng Cui, Zhiwen Geng, Haotao Li, Rui Li, Mengxia Lu, Yuqiao Wang, Lulu Xiao, Xinfeng Liu","doi":"10.1159/000545334","DOIUrl":"https://doi.org/10.1159/000545334","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the role of novel indicators related to obesity in predicting long-term functional outcomes and the risk of stroke recurrence in participants with first-ever acute ischemic stroke (AIS).</p><p><strong>Methods: </strong>The area and density of visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and skeletal muscle (SM) at the third lumbar level, as well as the VAT area (VATA)-to-SM area (SMA) ratio (VSR) and the SAT area-to-SMA ratio (SSR), were assessed using whole-abdominal CT upon admission. The primary endpoint was the recurrence of stroke. The secondary outcomes were all-cause mortality and cardio-cerebrovascular origin death (CCVD) specifically due to cardiovascular and cerebrovascular diseases. Cox's proportional hazards regression model was used to examine the associations between the novel indicators of obesity and clinical outcomes.</p><p><strong>Results: </strong>A total of 1007 participants were enrolled, with an average follow-up time of 1445 days. The participants in the high VSR group had a higher rate of stroke recurrence (adjusted hazard ratio, 2.06 [95% CI, 1.35-3.14]; p = 0.001). According to the adjusted analysis, high VSR was significantly associated with an increased risk of all-cause mortality (hazard ratio, 2.26 [95% CI, 1.58-3.24]; p < 0.001) and CCVD (hazard ratio, 2.49 [95% CI, 1.65-3.78]; p < 0.001).</p><p><strong>Conclusions: </strong>A higher VSR was associated with a higher risk of mortality and stroke recurrence in participants with first-ever AIS.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-19"},"PeriodicalIF":2.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes following acute ischaemic stroke in patients with comorbid cancer.","authors":"Noriko Sato, Fumi Kiyuna, Kayo Wakisaka, Yuichiro Ohya, Kana Ueki, Sohei Yoshimura, Kuniyuki Nakamura, Jun Hata, Yoshinobu Wakisaka, Tetsuro Ago, Masahiro Kamouchi, Takanari Kitazono, Ryu Matsuo","doi":"10.1159/000544700","DOIUrl":"https://doi.org/10.1159/000544700","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of comorbid cancer is higher in patients with ischaemic stroke than in the general population, and recent studies have attempted to clarify the relationship between the two. We observed that the evidence for the impact of comorbid cancer on post-stroke clinical outcomes was not established and aimed to investigate it among patients with new-onset acute ischaemic stroke.</p><p><strong>Methods: </strong>We evaluated 13,345 patients with acute ischaemic stroke who were functionally independent before onset (modified Rankin Scale [mRS] score of 0-2) and admitted to one of the seven stroke centres in Fukuoka, Japan, between June 2007 and September 2019. A total of 13,047 patients were included in the analyses after excluding those with missing potential confounders (n=13) or loss to follow-up (n=298). Comorbid cancer was diagnosed based on previous history or newly identified cancer during hospitalisation for the index stroke. Multivariable-adjusted Poisson regression analyses were conducted to assess the association of comorbid cancer with post-stroke outcomes: clinically assessed poor functional outcomes (mRS score, 3-6), functional dependency (mRS score, 3-5), and mortality (mRS score, 6) at 3 months after stroke onset.</p><p><strong>Results: </strong>Of 13,047 patients (aged 71.1±12.3 years, 62.8% men) with acute ischaemic stroke, 2,027 (15.6%) had comorbid cancer. Among those with no cancer, 24.0% recorded poor functional outcomes; with non-active cancer, 30.7%; and with active cancer, 46.1%. The risk ratios (95% confidence interval) for poor functional outcome at 3 months increased with active cancer (1.50 [1.37-1.65] vs. no cancer) and recently diagnosed cancer (7 months-4 years: 1.43 [1.28-1.59], ≤6 months: 1.53 [1.36-1.72]) after adjusting for potential confounders. These associations were observed for both 3-month functional dependency and mortality. No significant heterogeneity was observed in these associations across sex, nutritional status, inflammatory status, or coagulation status, except for age and stroke severity. The strongest association with 3-month poor functional outcome was observed for pancreatic cancer, followed by gallbladder and biliary tract, liver, and colon cancers.</p><p><strong>Conclusions: </strong>Comorbid cancer is likely to be independently associated with unfavourable outcomes in patients with acute ischaemic stroke.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-16"},"PeriodicalIF":2.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stroke Medicine is Frailty Medicine: Clinical and Research Priorities for Frailty in Stroke.","authors":"Nicholas R Evans, Jatinder S Minhas, Lucy C Beishon, Terence J Quinn","doi":"10.1159/000545288","DOIUrl":"10.1159/000545288","url":null,"abstract":"","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-12"},"PeriodicalIF":2.2,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of body mass index on outcome of Endovascular Thrombectomy with or without Intravenous Alteplase in Acute Stroke in China：A post-hoc Analysis of DIRECT-MT Trial.","authors":"Qingyuan Wu, Xiangyu Chen, Yina Wu, Limin Ma, Yongpin Chen, Wenqing Zhang, Rong Deng, Liu Jin, Lei Zhang, Zifu Li, Pengfei Xing, Yongwei Zhang, Pengfei Yang, Liu Yue, Peng Xie, Lijun Wang, Shengli Chen, Jianmin Liu","doi":"10.1159/000544907","DOIUrl":"https://doi.org/10.1159/000544907","url":null,"abstract":"<p><strong>Objective: </strong>The impact of body mass index (BMI) on outcomes after mechanical thrombectomy (MT) for large vessel occlusion acute ischemic stroke (LVOS) has been a subject of controversy, mainly due to the so-called \"obesity paradox\". The obesity paradox refers to the phenomenon where, contrary to expectations, overweight or obese individuals seem to have better clinical outcomes in certain disease states. This study aimed to investigate the relationship between BMI and the clinical prognosis of patients with LVOS treated with endovascular thrombectomy (EVT) combined with or without intravenous alteplase in DIRECT-MT.</p><p><strong>Methods: </strong>This is a post-hoc analysis of the DIRECT-MT randomized trial. Patients were randomly allocated to undergo EVT after alteplase intravenous thrombolysis (IVT) (IVT+EVT group) or EVT alone (EVT group) at a 1:1 ratio. Among 656 randomized patients, 645 with baseline BMI information were included, The BMI was analyzed as a categorical variable, all patients were categorized according to their BMI into 3 groups: 18.5 ≤ BMI ＜ 24 kg/m2 (normal weight), 24 ≤ BMI＜28 kg/m2 (overweight), BMI ≥ 28 kg/m2 (obese). The primary outcome was the 90-day modified Rankin Scale (mRS) score analyzed as a continuous variable. Multivariable ordinal logistic regression with an interaction term was used to estimate treatment allocation and the BMI subgroups.</p><p><strong>Results: </strong>A total of 645 patients were enrolled in this study, 373 (57.8%) were normal weight, 208 (32.2%) were overweight and 64 (10.0%) were obese. 175 (46.9%) normal weight patients, 114 (54.8%) overweight patients and 31 (48.4%) obese patients underwent direct EVT. Patients in the three groups were statistically different in age (71 versus 68, 66), time from randomization to groin puncture (31 versus 32, 39.5), time from randomization to revascularization (101.5 versus 92, 116), and time from admission to groin puncture (84 versus 83, 98.5). Other baseline and procedural characteristics were comparable. No significant difference for the ordinal mRS or 90 days mortality was observed by BMI [adjusted common odds ratio (acOR) was 0.92 (95% CI 0.64 to 1.32) for normal weight, 1.36 (95% CI 0.83 to 2.22) for overweight, and 1.09 (95% CI 0.45 to 2.64) for obese] and treatment allocation interaction [the adjusted P value for interaction was 0.335 (normal weight versus overweight), 0.761 (normal weight versus obese) and 0.733 (overweight versus obese)]. For the procedural complications and other clinical and imaging outcomes, no significant differences were observed between the BMI and treatment allocation.</p><p><strong>Conclusion: </strong>The results demonstrated that BMI had no association with final outcome whether the patient with LVOS underwent EVT alone or plus IVT for Chinese adults. Thus, the obesity paradox does not appear to pertain to EVT alone or plus IVT. Further studies are needed to confirm the finding.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-17"},"PeriodicalIF":2.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for incomplete occlusion in patients with small intracranial aneurysms (<7mm) after flow-diversion treatment: a multicenter experience.","authors":"Chi Huang, Xingwei Lei, Xin Feng, Xin Tong, Zhuohua Wen, Jiancheng Lin, Mengshi Huang, Chao Peng, Tao Wang, Wenxin Chen, Lele Dai, Xin Jin, Shixing Su, Xin Zhang, Xifeng Li, Zongduo Guo, Aihua Liu, Chuanzhi Duan","doi":"10.1159/000544991","DOIUrl":"https://doi.org/10.1159/000544991","url":null,"abstract":"<p><p>Introduction The indicator of flow diverters (FDs) received approval extension for small (<7 mm) unruptured intracranial aneurysms (UIAs). However, the factors related to aneurysm occlusion remain unclear. Thus, we conducted a multicenter analysis to explore the risk factors for incomplete occlusion (ICO) following FD implantation for small UIAs. Methods We retrospectively reviewed patients from 5 comprehensive hospitals in China with small UIAs treated with either Pipeline or Tubridge between September 2018 and September 2022. Baseline data were prospectively collected at admission. The relationship between baseline characteristics and occlusion status was analyzed and multivariate logistic regression models were performed to identify the independently related factors. Results A total of 565 patients with 565 small UIAs were enrolled. During a mean angiographic follow-up of 10.64 ± 5.99 months, ICO was detected in 116 cases (20.5%). After adjusting for candidate variables, hypertension (adjusted odds ratio [aOR] = 2.274, 95% confidence interval [CI] = 1.462-3.538, p <0.001), coronary disease (aOR = 2.742, 95%CI = 1.148-6.552, p = 0.023), larger aneurysm size (aOR = 1.833, 95%CI = 1.425-2.356, p <0.001), lower size ratio (SR, aOR = 0.380, 95% CI = 0.166-0.869, p = 0.022), and less coil application (aOR = 0.212, 95% CI = 0.061-0.741, p = 0.015) were independently associated with ICO of small UIAs. Conclusion Hypertension, coronary disease, larger aneurysm size, lower SR, and less coil application were independent predictors of ICO for small UIAs after FD implantation. Neurointerventionalists should focus more on blood pressure management and aneurysm morphological assessment in flow-diversion treatment for small UIAs.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-15"},"PeriodicalIF":2.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty in Stroke.","authors":"Jatinder S Minhas, Terence J Quinn, Nicholas R Evans, Lucy C Beishon","doi":"10.1159/000545033","DOIUrl":"10.1159/000545033","url":null,"abstract":"","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-2"},"PeriodicalIF":2.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nationwide prospective registry of endovascular thrombectomy for extra-large ischemic stroke with large vessel occlusion (XL STROKE): rationale and design.","authors":"Guangxiong Yuan, Lei Liu, Yong Liang, Junxiong Wu, Thanh N Nguyen, Shuai Wei, Tao Cui, Xiangdong Li, Zhengzhou Yuan, Shudong Liu, Guoyong Zeng, Zhongfan Ruan, Chong Zheng, Xiaolin Tan, Songlin Tang, Haizhen Hao, Haiyan Xia, Raul G Nogueira, Götz Thomalla, Bruce Campbell, Jeffrey L Saver, Qingwu Yang, Chen Long, Zhongming Qiu, Hongfei Sang","doi":"10.1159/000544844","DOIUrl":"https://doi.org/10.1159/000544844","url":null,"abstract":"<p><p>Introduction： The role of endovascular thrombectomy (EVT) for acute extra-large ischemic stroke patients with large vessel occlusion (LVO) is uncertain. We aimed to explore the clinical and safety outcomes of medical management (MM) plus EVT (EVT group) versus MM alone (MM group) among acute extra-large ischemic stroke patients with LVO within 24 hours of last known well. Methods： XL STROKE (endovascular thrombectomy for extra-large ischemic stroke) is an investigator-initiated, nationwide, prospective registry with blinded end point assessment performed at approximately 60 sites in China, and will enroll up to 990 acute ischemic stroke patients within 24 hours of last known well. Imaging inclusion criteria are occlusion of the internal carotid artery, or the middle cerebral artery M1 or M2 segments, and Alberta Stroke Program Early Computed Tomography Score of 0 to 2 or an ischemic-core volume ≥85ml. All patients will be dichotomized into EVT group and MM group according to whether they received EVT or not. The primary outcome is the level of disability on the modified Rankin Scale at 90±14 days. Safety outcomes include symptomatic intracranial hemorrhage within 48 hours, and mortality at 90±14 days. Conclusion： Results from XL STROKE registry will provide constructive evidence of improved disability outcomes and safety with EVT for acute extra-large ischemic stroke patients with LVO within 24 hours of last known well. Trial registrations: ClinicalTrials.gov, NCT06210633.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-14"},"PeriodicalIF":2.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prediction of hematoma growth in acute intracerebral hemorrhage: from 2-dimensional shape to 3-dimensional morphology.","authors":"Wen-Song Yang, Yi-Qing Shen, Qing-Jun Liu, Yong-Bo Ma, Jun-Meng Huang, Qing-Yuan Wu, Jing Wang, Chao-Yi Huang, Li-Bo Zhao, Qi Li, Peng Xie","doi":"10.1159/000544757","DOIUrl":"https://doi.org/10.1159/000544757","url":null,"abstract":"<p><strong>Introduction: </strong>The relationship between the 3-dimensional morphological features of hematoma and hematoma growth (HG) remains unclear. We aim to quantitatively assess the predictive value of 3-dimensional hematoma morphology for HG among patients with intracerebral hemorrhage (ICH).</p><p><strong>Methods: </strong>Our study comprised 312 consecutive ICH patients. Using semi-automated volumetric analysis software, we measured hematoma volumes and delineated the region of interest. We employed Python software to extract shape features, and receiver operating characteristic curve analysis to assess the predictive performance of hematoma morphology for HG. P value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Sphericity and SurfaceArea emerged as the most effective 3-dimensional hematoma morphological predictors for HG. Optimal cutoff points relating to HG were Sphericity ≤ 0.56 and SurfaceArea > 55 cm2. We subsequently constructed the 3-dimensional morphology models, including the probability of hematoma morphology (PHM) and the probability of comprehensive model (PCM), to predict HG. The PHM model outperformed the irregular hematoma (p = 0.007), island sign (p = 0.032), and satellite sign (p < 0.001) in predictive accuracy for HG. Amongst all prediction models, the PCM presented the highest predictive value for active bleeding.</p><p><strong>Conclusions: </strong>The Sphericity≤0.56 and SurfaceArea >55 cm2 could represent the optimal threshold for HG prediction. PHM was considered a reliable 3-dimensional morphology model for HG prediction. PCM tended to be a better model for risk stratification of active bleeding in acute ICH patients.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-22"},"PeriodicalIF":2.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Acupuncture on Dysphagia After Stroke: A Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials.","authors":"Jiongliang Zhang, Minmin Wu, Xinyue Li, Donghui Yu, Huanhuan Jia, Binhan Wang, Yuting Wang, Yumeng Su, Xiangyu Wei, Luwen Zhu","doi":"10.1159/000544743","DOIUrl":"https://doi.org/10.1159/000544743","url":null,"abstract":"<p><strong>Introduction: </strong>Post-stroke dysphagia (PSD) is a highly prevalent dysfunction after stroke, characterized by high mortality and seriously affecting the quality of life of patients. Previous studies have shown that acupuncture improves symptoms of PSD. However, repeated tests of significance may exaggerate Type I errors. To update the evidence on the effectiveness and safety of acupuncture for PSD using a meta-analysis and trial sequential analysis (TSA).</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science was conducted to identify randomized controlled trials evaluating the effects of acupuncture on PSD. Trials published up to September 15, 2024, meeting the predetermined inclusion criteria, were included.</p><p><strong>Results: </strong>Twenty studies involving 1,718 participants were included. Combined acupuncture with rehabilitation therapies significantly improved the Standard Swallowing Assessment (mean difference [MD] = -3.64, 95% confidence interval (CI): -4.72 to -2.56, p < 0.0001), Videofluoroscopic Swallowing Study scale (MD = 1.49, 95% CI: 0.89 to 2.09, p < 0.0001), Water Swallow Test (MD = -0.72, 95% CI: -0.96 to -0.47, p < 0.0001), and Swallowing Quality of Life Questionnaire (MD = 16.56, 95% CI: 9.94 to 23.18, p < 0.0001). TSA indicated that the sample size exceeded the required information size. In addition, acupuncture showed safety for PSD treatment (relative ratio [RR] = 1.23, 95% CI: 0.70 to 2.17, p = 0.48); however, the sample size was insufficient.</p><p><strong>Conclusions: </strong>TSA demonstrated the positive effects of acupuncture on swallowing function in patients with PSD. Nonetheless, high-quality trials are needed to validate the safety of acupuncture.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-25"},"PeriodicalIF":2.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging Thrombolysis versus Direct Mechanical Thrombectomy in acute Basilar artery occlusion due to different stroke etiologies.","authors":"Ligen Fan, Chuanyong Qu, Xiao Zhang, Xuemei Chen, Junlin Feng, Peng Chen, Zhiqiang Han, Wen Sun, Jinou Zheng","doi":"10.1159/000544034","DOIUrl":"https://doi.org/10.1159/000544034","url":null,"abstract":"<p><strong>Introduction: </strong>Stroke etiology could influence treatment decisions. This study aims to evaluate the efficacy and safety of bridging thrombolysis (BT) compared to direct endovascular treatment (EVT) in patients with basilar artery occlusion (BAO), stratified by stroke subtype.</p><p><strong>Methods: </strong>Data were collected from the PERSIST multicenter retrospective registry, enrolling patients with acute symptomatic BAO treated with EVT. Stroke subtypes were classified based on the TOAST criteria into large-artery atherosclerosis (LAA), cardioembolism (CE), and Others causes. A propensity score-matched analysis was performed to compare outcomes between patients receiving BT and those undergoing direct EVT. The primary outcome was a favorable functional outcome (mRS 0-3) at 90 days. Secondary outcomes included functional independence (mRS 0-2), 90-day mortality, and symptomatic intracranial hemorrhage (sICH).</p><p><strong>Results: </strong>A total of 577 BAO patients were included, with 376 patients classified as LAA, 119 as CE, and 82 as other causes. In the LAA subgroup, BT was associated with a higher likelihood of favorable outcomes compared to EVT (53.8% vs. 34.4%; OR 1.29; 95% CI 1.02-1.65). In the CE subgroup, BT was associated with an increased likelihood of functional independence (mRS 0-2) at 90 days (OR 1.57; 95% CI 1.01-2.51). No significant increase in the risk of sICH or 90-day mortality was observed in any of the subgroups following BT.</p><p><strong>Conclusion: </strong>BT appears to be an effective and safe treatment strategy in patients with BAO, particularly in those with LAA and CE etiologies. BT was associated with better functional outcomes compared to direct EVT without increasing the risk of hemorrhagic complications. These findings suggest that stroke subtype should be considered when tailoring treatment strategies for BAO patients. Further prospective randomized trials are needed to confirm these results.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-19"},"PeriodicalIF":2.2,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}