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Background <p>Sex-related differences in outcomes after mechanical thrombectomy (MT) for distal medium vessel occlusion (DMVO) stroke remain uncertain. While unadjusted differences have been reported in stroke populations, it is unclear whether biological sex independently influences outcomes after accounting for major prognostic factors.</p> Methods <p>We performed a&#xa0;retrospective, multicenter analysis of the MAD-MT registry. Patients with acute DMVO who underwent MT were included. Propensity score matching (PSM) was employed. The primary outcome was functional independence (modified Rankin Scale [mRS] score&#xa0;0–2) at 90&#xa0;days. Secondary outcomes included excellent outcome (mRS 0–1), day&#xa0;1 NIHSS shift, and reperfusion success. Safety outcomes included mortality and symptomatic intracerebral hemorrhage.</p> Results <p>Before matching, 1147 females and 1062 males were included. After 1:1 PSM (748 patients in each group), the groups were balanced in baseline characteristics. The median age was 75&#xa0;years in both groups. At 90&#xa0;days, 51% of females and 54% of males achieved mRS 0–2 (<i>P</i> = 0.38). NIHSS shift from baseline to day&#xa0;1 was similar (median −2 in both groups), and successful reperfusion (Thrombolysis in Cerebral Infarction 2b–3) was achieved in 86% of females and 89% of males (<i>P</i> = 0.18). Mortality was 18.4% in females and 15.5% in males (<i>P</i> = 0.11). Symptomatic intracerebral hemorrhage occurred in 8.3% of females and 7.7% of males (<i>P</i> = 0.67).</p> Conclusions <p>After adjustment for age, baseline disability, and vascular risk factors, biological sex was not independently associated with functional or safety outcomes following mechanical thrombectomy for DMVO stroke.</p>

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Sex-Related Differences in Outcomes of Endovascular Treatment of Distal Medium Vessel Occlusion Strokes

  • 期刊论文

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  • 发表日期：

    2026年3月10日

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  • Hamza Adel Salim,
  • Vivek Yedavalli,
  • Dhairya Lakhani,
  • Fathi Milhem,
  • Basel Musmar,
  • Nimer Adeeb,
  • Davide Simonato,
  • Yan-Lin Li,
  • Orabi Hajjeh,
  • Muhammed Amir Essibayi,
  • Nils Henninger,
  • Sri Hari Sundararajan,
  • Anna Luisa Kühn,
  • Jane Khalife,
  • Sherief Ghozy,
  • Luca Scarcia,
  • Leonard LL. Yeo,
  • Benjamin YQ Tan,
  • Robert W. Regenhardt,
  • Jeremy J. Heit,
  • Aymeric Rouchaud,
  • Jens Fiehler,
  • Sunil Sheth,
  • Ajit S. Puri,
  • Christian Dyzmann,
  • Marco Colasurdo,
  • Leonardo Renieri,
  • João Pedro Filipe,
  • Pablo Harker,
  • Răzvan Alexandru Radu,
  • Mohamad Abdalkader,
  • Piers Klein,
  • Takahiro Ota,
  • Ashkan Mowla,
  • Kareem El Naamani,
  • Pascal Jabbour,
  • Arundhati Biswas,
  • Frédéric Clarençon,
  • James E. Siegler,
  • Thanh N. Nguyen,
  • Ricardo Varela,
  • Amanda Baker,
  • David Altschul,
  • Nestor R. Gonzalez,
  • Markus A. Möhlenbruch,
  • Vincent Costalat,
  • Benjamin Gory,
  • Christian Paul Stracke,
  • Constantin Hecker,
  • Gaultier Marnat,
  • Hamza Shaikh,
  • Christoph J. Griessenauer,
  • David S. Liebeskind,
  • Alessandro Pedicelli,
  • Andrea M. Alexandre,
  • Tobias D. Faizy,
  • Illario Tancredi,
  • Erwah Kalsoum,
  • Boris Lubicz,
  • Aman B. Patel,
  • Maurizio Fuschi,
  • Max Wintermark,
  • Adrien Guenego,
  • Adam A. Dmytriw

摘要

Background

Sex-related differences in outcomes after mechanical thrombectomy (MT) for distal medium vessel occlusion (DMVO) stroke remain uncertain. While unadjusted differences have been reported in stroke populations, it is unclear whether biological sex independently influences outcomes after accounting for major prognostic factors.

Methods

We performed a retrospective, multicenter analysis of the MAD-MT registry. Patients with acute DMVO who underwent MT were included. Propensity score matching (PSM) was employed. The primary outcome was functional independence (modified Rankin Scale [mRS] score 0–2) at 90 days. Secondary outcomes included excellent outcome (mRS 0–1), day 1 NIHSS shift, and reperfusion success. Safety outcomes included mortality and symptomatic intracerebral hemorrhage.

Results

Before matching, 1147 females and 1062 males were included. After 1:1 PSM (748 patients in each group), the groups were balanced in baseline characteristics. The median age was 75 years in both groups. At 90 days, 51% of females and 54% of males achieved mRS 0–2 (P = 0.38). NIHSS shift from baseline to day 1 was similar (median −2 in both groups), and successful reperfusion (Thrombolysis in Cerebral Infarction 2b–3) was achieved in 86% of females and 89% of males (P = 0.18). Mortality was 18.4% in females and 15.5% in males (P = 0.11). Symptomatic intracerebral hemorrhage occurred in 8.3% of females and 7.7% of males (P = 0.67).

Conclusions

After adjustment for age, baseline disability, and vascular risk factors, biological sex was not independently associated with functional or safety outcomes following mechanical thrombectomy for DMVO stroke.