Impact of vascular risk factors on endovascular mechanical thrombectomy outcomes in patients with stroke

Endovascular mechanical thrombectomy (MT) is a recommended treatment for acute ischemic stroke due to large vessel occlusion (LVO). The objective of the present study was to evaluate the impact of vascular risk factors on the outcome of MT outcomes in patients with stroke with LVO and to determine the prevalence of structural epilepsy in these patients. This was a retrospective cohort study involving patients with stroke between 20 and 80 years of age with LVO who underwent MT. The clinical outcomes post-MT were assessed using the Modified Thrombolysis in Cerebral Infarction score. A total of 56 individuals were included in the study, with a structural epilepsy prevalence of 14.29%. Patients who received intravenous tissue plasminogen activator (TPA) in addition to MT were less likely to develop structural epilepsy (P=0.041). A substantial number of patients (85.8%, combined Grades 3 and 2B) achieved successful reperfusion. The significant risk factors for hemorrhagic transformation include age [odds ratio (OR), 2.5; 95% CI: 1.8-3.6; P=0.001], hypertension (OR, 3; 95% CI: 2.2-4.1; P<0.001), diabetes (OR, 1.8; 95% CI: 1.2-2.7; P=0.008), heart failure (OR, 1.5; 95% CI: 1.0-2.2; P=0.050) and cardiac thrombus (OR, 2.0; 95% CI: 1.3-3.1; P=0.005). Age was a significant predictor, with patients aged 65 years or younger having an OR of 2.3 (95% CI: 1.5-3.5, P=0.002). In conclusion, the present study provides valuable insights into the impact of vascular risk factors on the outcomes of MT in patients with stroke with LVO and highlights key predictors of post-procedural complications, including structural epilepsy and hemorrhagic transformation.