Clinical efficacy and safety of acupotomy for acute ischemic stroke: A retrospective study

Acute ischemic stroke (AIS) is a major cause of persistent neurological impairment and functional dependence. Adjunctive interventions that may enhance rehabilitation-associated recovery warrant pragmatic evaluation in routine clinical settings. This retrospective cohort study consecutively enrolled adults with imaging-confirmed AIS admitted between January 1, 2018 and December 31, 2021. Patients received either standard post-stroke rehabilitation alone (control, n = 61) or standard rehabilitation plus acupotomy (observation, n = 98). Baseline demographics, vascular risk factors, stroke characteristics (including Trial of ORG 10172 in Acute Stroke Treatment [TOAST] classification and infarct territory), and admission status were extracted from electronic records. Primary outcomes were neurological and functional status at discharge assessed by the National Institutes of Health Stroke Scale (NIHSS) and Modified Barthel Index (MBI), with change scores calculated as ΔNIHSS (baseline minus discharge) and ΔMBI (discharge minus baseline). Safety outcomes included procedure-related events, overall adverse events, and serious adverse events. Baseline characteristics were comparable between groups. At discharge, the acupotomy plus rehabilitation group had a lower NIHSS score (4.46 ± 4.05 vs 6.00 ± 4.29; P = .026) and greater ΔNIHSS (4.67 ± 2.19 vs 3.22 ± 2.49; P < .001). Functional recovery favored adjunctive acupotomy, with higher discharge MBI (76.66 ± 22.85 vs 60.68 ± 25.75; P < .001) and greater ΔMBI (28.25 ± 14.05 vs 17.82 ± 10.45; P < .001). Procedure-related events were infrequent, and overall and serious adverse event rates were similar. Treatment effects were directionally consistent across prespecified subgroups without significant interaction. Adjunctive acupotomy was associated with improved short-term neurological and functional outcomes without an observed increase in serious safety events in hospitalized AIS patients.