Zülfikar MEMİŞ, Bahar İNCİRCİ, İrem KURU, Ayşe Özlem ÇOKAR
Northwestern Medical Journal - 2026;6(1):289-298
Aim: Although successful recanalization is frequently achieved in acute ischemic stroke, favorable clinical outcomes are not universal. Multiple independent factors influence post-thrombectomy prognosis. This study aimed to identify the determinants of good clinical outcomes following mechanical thrombectomy (MT) in patients with acute ischemic stroke. Methods: We retrospectively reviewed patients who underwent MT and/or intravenous thrombolytic therapy at our comprehensive stroke center between 2022 and 2023. Patients were classified by occlusion site: Group 1-middle cerebral artery (MCA, M1-M2) and anterior cerebral artery (ACA, A1); Group 2-internal carotid artery (ICA, cervical/distal) and tandem occlusions; Group 3-posterior circulation (distal vertebral, basilar, posterior cerebral artery (PCA) P1). Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS), and collateral circulation was graded with the TAN score for MCA occlusions. The modified Rankin Scale (mRS) score at 3 months was recorded in patients achieving successful recanalization (modified Thrombolysis in Cerebral Infarction (mTICI) 2b-3). Independent predictors of mRS were analyzed. Results: Among 140 patients (57.9% male; median age, 69.5 years), successful recanalization was achieved in 85%. Poor outcome (mRS >=3) was associated with older age, higher baseline NIHSS, elevated glucose, and higher 24-hour hemorrhage rates. Good outcome (mRS <=2) correlated with higher mTICI and TAN scores. Conclusion: Baseline and 24-hour NIHSS scores, collateral circulation, glucose level, and early intracranial hemorrhage are independent predictors of clinical outcome following MT in acute ischemic stroke.
