Endovascular Thrombectomy for Acute Ischemic Stroke Patients with Pre-existing mRS 3

Overview

This study evaluates the effectiveness and safety of endovascular thrombectomy (EVT) in patients with acute ischemic stroke and a pre-stroke modified Rankin Scale (mRS) score of 3.

Background

Reperfusion therapy is established for patients with acute ischemic stroke but is less understood in those with pre-existing disability. Patients with a pre-stroke mRS score of 3 are often excluded from trials, yet they represent a significant portion of stroke cases. Understanding treatment outcomes in this group is crucial as the population ages and the incidence of moderate pre-stroke disability increases.

Data Highlights

Key Findings

• EVT significantly increased the likelihood of returning to pre-stroke functional status compared to MT (OR 7.63).
• IVT did not show a significant benefit over MT (OR 1.15).
• EVT was associated with a favorable shift in the full mRS distribution (common OR 0.32).
• Neither EVT nor IVT increased the risk of symptomatic hemorrhagic transformation or mortality.
• Patients with pre-stroke mRS score of 3 constitute a notable proportion of acute ischemic stroke cases.

Clinical Implications

Clinicians should consider the findings in the context of existing guidelines and patient selection criteria.

Conclusion

This study evaluates EVT in patients with acute ischemic stroke and pre-stroke mRS score of 3.

Related Resources & Content

1. Evaluation of Immediate Versus Delayed Stenting Following Thrombectomy Failure in Patients with Intracranial Atherosclerosis-Induced Large Vessel Occlusion, 2025 -- Springer
2. Factors Influencing Three-Month Functional Outcomes in Ischemic Stroke Patients with Discharge Disability After Endovascular Therapy: A Multi-Center Observational Study of 836 Individuals, 2025 -- Springer
3. Tenecteplase Prior to EVT Did Not Improve Stroke Outcomes, 2023 -- Conexiant
4. Long-term outcomes of endovascular thrombectomy vs. medical care in patients with large ischemic stroke: a systematic review and meta-analysis of randomized controlled trials, 2026 -- Frontiers in Neurology
5. 2026 Guideline for the Early Management of Patients With AIS, American Heart Association
6. Endovascular treatment in acute ischemic stroke patients with pre-stroke disability: A systematic review and meta-analysis, 2023 -- PubMed
7. Mechanical Thrombectomy in Prestroke Disability: Data From the Italian Endovascular Stroke Registry, 2025
8. 2026 Guideline for the Early Management of Patients With AIS - Professional Heart Daily | American Heart Association
9. Endovascular treatment in acute ischemic stroke patients with pre-stroke disability: A systematic review and meta-analysis - PubMed
10. Mechanical Thrombectomy in Prestroke Disability: Data From the Italian Endovascular Stroke Registry