Association between initial NIHSS score and recanalization rate after endovascular thrombectomy

Area of Science:

• Neurology
• Interventional Radiology
• Stroke Medicine

Background:

• The National Institutes of Health Stroke Scale (NIHSS) and successful recanalization are key to stroke outcomes.
• The relationship between NIHSS score and recanalization rates after endovascular therapy (EVT) remains unclear.

Purpose of the Study:

• To investigate whether the rate of successful recanalization following EVT is influenced by the patient's NIHSS score.
• To determine the predictive value of NIHSS score for successful recanalization in major artery occlusion.

Main Methods:

• Analysis of a prospective EVT registry including patients with internal carotid artery or middle cerebral artery occlusions.
• Successful recanalization defined as Thrombolysis in Cerebral Infarction (TICI) scale ≥2b.
• Evaluation of recanalization rates across NIHSS score subgroups (0-8, 9-16, 17-24, >24) and multivariate regression analysis.

Main Results:

• 183 patients (mean age 76, 60% male) were analyzed; 80% achieved successful recanalization.
• Patients with successful recanalization had lower NIHSS scores (18 vs. 24, p<0.001).
• Recanalization rates decreased with increasing NIHSS score (100% for 0-8, 88% for 9-16, 81% for 17-24, 60% for >24; p<0.001). NIHSS score was an independent predictor (OR 0.905, p=0.013).

Conclusions:

• NIHSS score is a significant predictor of successful recanalization in patients undergoing EVT for major artery occlusion.
• Successful recanalization is more likely in patients with milder strokes (lower NIHSS scores).
• NIHSS score can help anticipate EVT outcomes in stroke patients.