P115 Effectiveness and safety of mechanical thrombectomy in mild stroke: insights from the ASSIST registry

<h3>Introduction</h3> Mechanical thrombectomy (MT) is effective for acute ischemic stroke, yet its efficacy in mild stroke remains unclear. <h3>Aim of Study</h3> This study evaluates MT’s effectiveness and safety in low NIHSS patients and assesses different MT strategies’ impact on procedural success and clinical outcomes. <h3>Methods</h3> Data from the ASSIST Registry were analyzed, categorizing patients into mild (NIHSS≤5) and moderate-severe (NIHSS&gt;5) stroke groups. Baseline characteristics, procedural parameters, angiographic and imaging outcomes, clinical outcomes, and safety endpoints were compared. Within the mild stroke subgroup, outcomes were compared between different MT techniques. <h3>Results</h3> Among 1486 patients, 145 had minor ischemic stroke (10%). These had higher rates of excellent functional outcomes (mRS 0-1) at 90 days (80.2% vs. 44.4%, P&lt;.0001) and greater functional independence (mRS 0–2) (86.4% vs. 55.7%, P&lt;.0001) than moderate-severe stroke patients. Procedural success rates were similar between groups, while safety outcomes, except mortality, were comparable. No statistical differences were observed in treatment techniques within the mild stroke subgroup. A significant predictor of early neurological deterioration (END) in mild stroke patients was the total number of passes (OR 1.56, 95% CI 1.09–2.25, P=.018). Patients with END were more likely to have an unfavourable functional outcome (mRS 3-6) at 90 days (80% vs. 6%, P&lt;0.0001). <h3>Conclusion</h3> MT is effective and safe in mild stroke, with better outcomes than moderate-severe strokes. Procedural success did not vary among MT techniques in mild stroke. The total number of passes predicts END, which suggests a casual pathway that requires further exploration. <h3>Disclosure of Interest</h3> no.