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Purpose <p>EVT is standard care for acute ischemic stroke (AIS) due to large vessel occlusion (LVO), but benefit with mild stroke (NIHSS ≤ 5) remains unclear.</p> Methods <p>Patients from the INSPIRE‑S global registry with AIS treated with Medtronic Neurovascular devices on the first pass were grouped by mild stroke (NIHSS ≤ 5) and moderate-to-severe stroke (NIHSS &gt; 5) at baseline. Clinical and safety outcomes were compared, with analysis for the subset treated with Solitaire™ on first pass with or without aspiration.</p> Results <p>From May 2020–December 2022, 801 patients (29&#xa0;sites, 13&#xa0;countries) met eligibility criteria and were enrolled into stent retriever, aspiration alone, or combination therapy cohorts. For this analysis, outcomes were compared by baseline NIHSS: mild stroke (<i>n</i> = 75) versus moderate-to-severe stroke (<i>n</i> = 713). Mild stroke patients had higher rates of 90-day mRS 0–2 (75.3% vs 53.0%; <i>p</i> &lt; 0.001), shorter hospital stay (5.6 vs.&#xa0;8.7; <i>p</i> = 0.006), lower mortality (4.0% vs. 14.4%; <i>p</i> = 0.008), with similar symptomatic intracranial hemorrhage (sICH), stroke, first-pass and final revascularization rates compared to moderate-to-severe stroke. Solitaire™ subset results matched Total MT cohort. Mild stroke had delayed stroke onset to arterial puncture (372.6 vs. 257.6 mins; <i>p</i> &lt; 0.001), and more MCA-M2 occlusions (40.0% vs. 18.7%; <i>p</i> &lt; 0.001). Good clinical outcomes in mild stroke were linked to younger age, fewer neurological deficits and less sICH.</p> Conclusion <p>INSPIRE‑S observed that mild stroke patients had better functional outcomes and lower mortality than moderate-to-severe stroke patients. With mild stroke, younger age, fewer early neurological deficits and less sICH were associated with good clinical outcome. Ongoing randomized clinical trials are still required for treatment recommendations for patients with mild stroke.</p>

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Outcomes for Mild Stroke Patients in INSPIRE-S Global Registry

  • 期刊论文

  • 发表日期：

    2026年4月24日

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  • Pasquale Mordasini,
  • Markus Möhlenbruch,
  • Sanjeev Nayak,
  • Christophe Cognard,
  • Jans Fiehler,
  • Alicia M Hall,
  • Isabel Huang,
  • Marc Ribo,
  • The INSPIRE-S Investigators .

摘要

Purpose

EVT is standard care for acute ischemic stroke (AIS) due to large vessel occlusion (LVO), but benefit with mild stroke (NIHSS ≤ 5) remains unclear.

Methods

Patients from the INSPIRE‑S global registry with AIS treated with Medtronic Neurovascular devices on the first pass were grouped by mild stroke (NIHSS ≤ 5) and moderate-to-severe stroke (NIHSS > 5) at baseline. Clinical and safety outcomes were compared, with analysis for the subset treated with Solitaire™ on first pass with or without aspiration.

Results

From May 2020–December 2022, 801 patients (29 sites, 13 countries) met eligibility criteria and were enrolled into stent retriever, aspiration alone, or combination therapy cohorts. For this analysis, outcomes were compared by baseline NIHSS: mild stroke (n = 75) versus moderate-to-severe stroke (n = 713). Mild stroke patients had higher rates of 90-day mRS 0–2 (75.3% vs 53.0%; p < 0.001), shorter hospital stay (5.6 vs. 8.7; p = 0.006), lower mortality (4.0% vs. 14.4%; p = 0.008), with similar symptomatic intracranial hemorrhage (sICH), stroke, first-pass and final revascularization rates compared to moderate-to-severe stroke. Solitaire™ subset results matched Total MT cohort. Mild stroke had delayed stroke onset to arterial puncture (372.6 vs. 257.6 mins; p < 0.001), and more MCA-M2 occlusions (40.0% vs. 18.7%; p < 0.001). Good clinical outcomes in mild stroke were linked to younger age, fewer neurological deficits and less sICH.

Conclusion

INSPIRE‑S observed that mild stroke patients had better functional outcomes and lower mortality than moderate-to-severe stroke patients. With mild stroke, younger age, fewer early neurological deficits and less sICH were associated with good clinical outcome. Ongoing randomized clinical trials are still required for treatment recommendations for patients with mild stroke.