Evidence map›Paper›PMID 40227296›Full record

ArticleNeuroradiology2025

Early neurological deterioration after endovascular treatment for acute stroke with mild symptoms.

Satoru Fujiwara, Kazutaka Uchida, Tsuyoshi Ohta, Nobuyuki Ohara, Michi Kawamoto, Hiroshi Yamagami, Mikito Hayakawa, Akira Ishii, Koji Iihara, Hirotoshi Imamura and 5 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Neuroradiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Systemic immune-inflammation index predicts hemorrhagic transformation after endovascular therapy for ischemic stroke.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Satoru FujiwaraKobe City Medical Center General Hospital, Kobe, Japan.
Kazutaka UchidaHyogo Medical University, Nishinomiya, Japan. kuchidans@gmail.com.
Tsuyoshi OhtaKobe City Medical Center General Hospital, Kobe, Japan.
Nobuyuki OharaKobe City Medical Center General Hospital, Kobe, Japan.
Michi KawamotoKobe City Medical Center General Hospital, Kobe, Japan.
Hiroshi YamagamiUniversity of Tsukuba, Tsukuba, Japan.
Mikito HayakawaUniversity of Tsukuba, Tsukuba, Japan.
Akira IshiiJuntendo University, Tokyo, Japan.
Koji IiharaNational Cerebral and Cardiovascular Center, Suita, Japan.
Hirotoshi ImamuraNational Cerebral and Cardiovascular Center, Suita, Japan.
Yuji MatsumaruUniversity of Tsukuba, Tsukuba, Japan.
Chiaki SakaiKyoto University, Kyoto, Japan.
Tetsu SatowKindai University, Osaka-Sayama, Japan.
Shinichi YoshimuraHyogo Medical University, Nishinomiya, Japan.
Nobuyuki SakaiKobe City Medical Center General Hospital, Kobe, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeEndovascular treatment (EVT) for acute ischemic stroke (AIS) with mild symptoms (National Institute of Health Stroke Scale [NIHSS] score of ≤ 5) has a specific concern about early neurological deterioration (END) after the procedure, but its significance remains unclear. This study aims to examine the prognostic impact and characteristics of END in this patient population.

methodsWe conducted a post-hoc analysis of the Japan Registry of NeuroEndovascular Therapy 4, enrolling 13,479 patients who underwent EVT for AIS at 166 participating centers between 2015 and 2019. We included patients with AIS and NIHSS scores ≤ 5 and compared outcomes (modified Rankin Scale [mRS] score at 30 days) between patients with and without END after EVT. Multivariate logistic regression models were used to explore associations between END and outcomes and risk factors for END.

resultsOf 503 patients analyzed, 66 (13%) developed END. Patients who developed END had a lower proportion of mRS scores of 0-2 at 30 days than the No-END group (17% vs. 80%, P < 0.0001), with an adjusted odds ratio (OR) of 0.04 (95% confidence interval [CI], 0.02-0.11). Mortality within 30 days was higher among patients with END (9.1% vs. 0.7%, P < 0.0001). A multivariable logistic regression model identified that factors associated with END included age ≥ 75 years (adjusted OR 3.67; 95% CI, 1.78-7.55), ASPECTS (adjusted OR 0.82; 95% CI, 0.69-0.97), NIHSS scores before EVT of 0-2 compared with those of 3-5 (adjusted OR 2.11; 95% CI, 1.04-4.25), and unsuccessful recanalization (adjusted OR 8.39; 95% CI, 3.90-18.0).

conclusionEND after EVT for AIS with mild symptoms was relatively common and associated with worse outcomes. Risk stratification for END and successful recanalization would be crucial, particularly for EVT candidates with mild symptoms.

Indexed as

Endovascular ProceduresIschemic StrokeAgedAged, 80 and overClinical DeteriorationFemaleHumansJapanMaleMiddle AgedPrognosisRegistriesRisk FactorsTreatment OutcomeAcute ischemic strokeEarly neurological deteriorationEndovascular treatmentNIHSS score

Identifiers

PMID40227296
PMCPMC12125113

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