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Updated: May 25, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Deep medullary vein drainage and unfavorable outcomes in stroke patients after endovascular therapy: a retrospective

Jiating Wei1, Tao Lu2, Siyu Li3

  • 1Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, Guangdong, 510080, People's Republic of China.

BMC Neurology
|May 23, 2026
PubMed

Insights

Disruption of deep medullary veins (DMVs) drainage is linked to poor outcomes after endovascular thrombectomy (EVT) for ischemic stroke. Maintaining DMV continuity may improve patient prognosis following EVT.

Area of Science:

  • Neurology
  • Vascular Neurology
  • Interventional Neurology

Background:

  • Ischemic stroke involving the middle cerebral artery (MCA) or internal carotid artery (ICA) often affects deep white matter.
  • Deep white matter drains via deep medullary veins (DMVs).
  • The impact of disrupted DMVs drainage on outcomes after endovascular thrombectomy (EVT) is unclear.

Purpose of the Study:

  • To investigate the association between DMVs continuity and prognosis in patients undergoing EVT for MCA or ICA occlusion.
  • To determine if DMVs integrity is a predictor of outcomes after EVT.

Main Methods:

  • Retrospective observational study including 61 patients with MCA or ICA occlusion treated with EVT.
  • Assessment of DMVs continuity using susceptibility-weighted imaging (SWI) post-EVT.
  • Modified Rankin Scale (mRS) recorded at 90 days; analysis using logistic regression and ROC curves.

Main Results:

  • 49.2% of patients had unfavorable outcomes (mRS 2-6).
  • DMVs discontinuity was significantly more frequent in patients with unfavorable outcomes (70.0% vs. 41.9%, P=0.040).
  • DMVs discontinuity independently predicted unfavorable outcomes (aOR=3.23). A combined model including DMVs status, NIHSS, and collateral status predicted prognosis with an AUC of 0.81.

Conclusions:

  • Impaired DMVs drainage is associated with unfavorable outcomes post-EVT in ischemic stroke patients.
  • DMVs continuity may serve as a prognostic marker in stroke patients undergoing EVT.
Abstract

Keywords:
Endovascular therapyFutile recanalizationIschemic strokeVein drainage

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