Stroke Preventability in Large Vessel Occlusion Treated With Mechanical Thrombectomy

Area of Science:

• Neurology
• Cardiology
• Public Health

Background:

• Mechanical thrombectomy is a critical treatment for large vessel occlusion strokes.
• The preventability of strokes requiring mechanical thrombectomy remains largely unquantified.
• Optimizing stroke prevention strategies is crucial for reducing healthcare burdens.

Purpose of the Study:

• To determine the preventability of strokes in patients undergoing mechanical thrombectomy for large vessel occlusion.
• To analyze the factors associated with stroke preventability in this patient cohort.

Main Methods:

• Retrospective analysis of 300 patients treated with mechanical thrombectomy for large vessel occlusion (2008-2019).
• Evaluation of stroke preventability using a Stroke Preventability Score (SPS) based on hypertension, hyperlipidemia, atrial fibrillation, and prior stroke history.
• Correlation of SPS with NIH Stroke Scale (NIHSS) at onset and modified Rankin Scale (mRS) at 90 days.

Main Results:

• 23% of patients had highly preventable strokes (SPS ≥ 4), with inadequately treated atrial fibrillation being the most common factor (85%).
• Higher stroke preventability was associated with higher NIHSS scores at onset (p=0.03) and worse mRS outcomes at 90 days (p=0.04).
• Stroke preventability showed a significant correlation with age (r=0.32, p<0.0001).

Conclusions:

• A significant proportion of strokes treated with mechanical thrombectomy are preventable.
• Improved management of risk factors, especially atrial fibrillation, in the elderly is essential for stroke prevention.
• Targeted prevention efforts are needed to reduce the incidence of severe strokes requiring mechanical thrombectomy.