TY - JOUR
T1 - Sex differences in outcomes after endovascular treatment in posterior circulation stroke
T2 - results from the MR CLEAN Registry
AU - Ali, Mariam
AU - Dekker, Luuk
AU - Ali, Mahsoem
AU - Van Zwet, Erik W.
AU - Hofmeijer, Jeanette
AU - Nederkoorn, Paul J.
AU - Majoie, Charles B.L.M.
AU - van Es, Adriaan C.G.M.
AU - Uyttenboogaart, Maarten
AU - van der Meij, Anne
AU - van Walderveen, Marianne A.A.
AU - Visser, Marieke C.
AU - Dippel, Diederik W.J.
AU - Schonewille, Wouter J.
AU - van den Wijngaard, Ido R.
AU - Kruyt, Nyika D.
AU - Wermer, Marieke J.H.
AU - the MR CLEAN Registry Investigators
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2025.
PY - 2024/12/26
Y1 - 2024/12/26
N2 - Background: Women with anterior circulation large vessel occlusion (LVO) have been reported to have worse outcomes after endovascular treatment (EVT) than men. Whether these disparities also exist in LVO of the posterior circulation is yet uncertain. We assessed sex differences in clinical, technical, and safety outcomes of EVT in posterior circulation LVO.Methods: We used data of patients with posterior circulation LVO included in the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) Registry (2014–2018). Primary outcome was the modified Rankin Scale (mRS) score at 90 days assessed with multivariable ordinal regression analysis. Secondary outcomes included favorable functional outcome (mRS ≤3), functional independence (mRS ≤2), death within 90 days, National Institutes of Health Stroke Scale (NIHSS) score 24–48 hours postintervention, complications, successful reperfusion (extended Thrombolysis in Cerebral Ischemia 2B-3), and procedure duration analyzed with multivariable logistic and linear regression analyses.Results: We included 264 patients (42% women). Compared with men, women were older (median age 68 vs 63 years), more often had prestroke disability (mRS ≥1: 37% vs 30%), and received intravenous thrombolytics less often (45% vs 56%). Clinical outcomes were similar between sexes (adjusted (common) OR (aOR) 0.82, 95% CI 0.51 to 1.34; favorable functional outcome 50% vs 43%, aOR 1.31, 95% CI 0.77 to 2.25; death 32% vs 29%, aOR 0.98, 95% CI 0.52 to 1.84). In addition, NIHSS score after 24–48 hours (median 7 vs 9), successful reperfusion (77% vs 73%), and complications did not differ between men and women.Conclusions: Outcomes in women treated with EVT for posterior circulation LVO were similar compared with men despite less favorable baseline characteristics in women. Therefore men and women may benefit equally from EVT.
AB - Background: Women with anterior circulation large vessel occlusion (LVO) have been reported to have worse outcomes after endovascular treatment (EVT) than men. Whether these disparities also exist in LVO of the posterior circulation is yet uncertain. We assessed sex differences in clinical, technical, and safety outcomes of EVT in posterior circulation LVO.Methods: We used data of patients with posterior circulation LVO included in the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) Registry (2014–2018). Primary outcome was the modified Rankin Scale (mRS) score at 90 days assessed with multivariable ordinal regression analysis. Secondary outcomes included favorable functional outcome (mRS ≤3), functional independence (mRS ≤2), death within 90 days, National Institutes of Health Stroke Scale (NIHSS) score 24–48 hours postintervention, complications, successful reperfusion (extended Thrombolysis in Cerebral Ischemia 2B-3), and procedure duration analyzed with multivariable logistic and linear regression analyses.Results: We included 264 patients (42% women). Compared with men, women were older (median age 68 vs 63 years), more often had prestroke disability (mRS ≥1: 37% vs 30%), and received intravenous thrombolytics less often (45% vs 56%). Clinical outcomes were similar between sexes (adjusted (common) OR (aOR) 0.82, 95% CI 0.51 to 1.34; favorable functional outcome 50% vs 43%, aOR 1.31, 95% CI 0.77 to 2.25; death 32% vs 29%, aOR 0.98, 95% CI 0.52 to 1.84). In addition, NIHSS score after 24–48 hours (median 7 vs 9), successful reperfusion (77% vs 73%), and complications did not differ between men and women.Conclusions: Outcomes in women treated with EVT for posterior circulation LVO were similar compared with men despite less favorable baseline characteristics in women. Therefore men and women may benefit equally from EVT.
KW - NLA
UR - http://www.scopus.com/inward/record.url?scp=85182998608&partnerID=8YFLogxK
U2 - 10.1136/jnis-2023-021086
DO - 10.1136/jnis-2023-021086
M3 - Article
C2 - 38171605
AN - SCOPUS:85182998608
SN - 1759-8478
VL - 17
SP - e74-e82
JO - Journal of NeuroInterventional Surgery
JF - Journal of NeuroInterventional Surgery
IS - e1
M1 - jnis-2023-021086
ER -
