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Sex-Based Differences in Endovascular Thrombectomy Outcomes for Large Ischemic Stroke: A SELECT2 Subanalysis
Jenny P Tsai1, Thanh N Nguyen2, Deep K Pujara3
1Neurosurgery, Cleveland Clinic, OH (J.P.T.).
Stroke
|January 2, 2025
Summary
Endovascular thrombectomy (EVT) significantly improved functional outcomes for both men and women with large ischemic strokes. Treatment benefits were consistent across sexes, supporting EVT consideration for all eligible patients.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Clinical Trials
Background:
- Stroke outcomes vary between sexes due to social and biological factors.
- Investigating sex-based differences in endovascular thrombectomy (EVT) for large ischemic stroke is crucial.
Purpose of the Study:
- To evaluate clinical outcomes and EVT treatment effects in men versus women with large ischemic stroke.
- To determine if sex modifies the efficacy of EVT in acute ischemic stroke patients.
Main Methods:
- The SELECT2 trial subanalysis compared baseline characteristics and outcomes between sexes.
- Functional outcomes at 90-day and 1-year follow-ups were assessed using regression models.
- Sex-related effect modification on EVT treatment was examined.
Main Results:
- EVT improved functional outcomes, independence, and ambulation in both women and men compared to medical management.
- No significant sex-based heterogeneity was observed in EVT treatment effects.
- Increased age and infarct core volume were associated with decreased independent ambulation post-EVT in both sexes.
Conclusions:
- EVT offers consistent benefits for both men and women with large ischemic strokes.
- Age and infarct core volume independently predict ambulation outcomes.
- EVT should be considered for all eligible patients regardless of sex.
