Functional and angiographic outcomes after direct thromboaspiration for acute large vessel occlusion stroke: A single-center experience

Objective: To determine the Functional outcomes of Mechanical Thrombectomy (MT) by direct thromboaspiration in acute ischemic Large Vessel Occlusion (LVO) stroke. Methodology: Patients who received MT for acute ischemic LVO stroke from January 2024 to February 2026 were included in this retrospective observational cohort study, which was carried out in the Department of Neuro Endovascular Surgery at Punjab Institute of Neurosciences, Lahore, Pakistan. The Statistical Package for the Social Sciences (SPSS), version 29, was used to analyze the data. The mean National Institutes of Health Stroke Scale (NIHSS) score before and after the procedure was compared using the Wilcoxon signed-rank test following the computation of descriptive statistics. In acute ischemic LVO stroke, binary logistic regression analysis was used to find variables that independently predicted favorable functional outcomes following MT. Results: Of the total 98 patients, the mean age was 55.53±13.26 years with male predominance of 67.30% (66). On admission, the mean NIHSS score was 15.95±4.87. Intravenous tissue plasminogen activator (tPA) was given in 41.80% (41) cases. After the procedure, a significant reduction in mean NIHSS score was observed by the Wilcoxon signed-rank test, i.e., z=-8.136, p < 0.001. The post-procedural good functional outcomes (Modified Rankin Score [mRS]≤2) were observed in 41.8% (41) patients at 30 days. Almost 20% of patients had post-procedural asymptomatic intracranial hemorrhage (ICH), including reperfusion injuries (3%), with a 30-day stroke-related mortality rate of 15%. Admission-NIHSS (p<0.001) was the only independent predictor of favorable mRS after MT for acute ischemic LVO stroke, i.e., Odds Ratio (OR): 0.76, 95% Confidence Interval (CI): 0.676-0.866, p<0.001. Conclusion: MT in acute ischemic LVO stroke results in successful recanalization and good functional outcomes. Mean NIHSS score is a significant baseline prognostic factor that determines the outcomes of patients after MT.