ArticleFrontiers in neuroscience2026
Endovascular treatment and clinical outcomes in minor ischemic stroke due to large-vessel disease: a retrospective study.
Article in Frontiers in neuroscience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Patients with minor ischemic stroke may still experience early neurological deterioration when severe intracranial stenosis or occlusion is present. The optimal role of endovascular treatment (EVT) in this imaging-defined population remains uncertain. This study aimed to evaluate clinical outcomes associated with EVT and to explore prognostic factors in patients with minor ischemic stroke caused by major intracranial arterial disease. Methods: This retrospective observational cohort study included consecutive adults with admission National Institutes of Health Stroke Scale (NIHSS) score ≤ 5 and severe intracranial stenosis or occlusion treated between January 2023 and December 2025. Patients were classified according to final treatment received as medical treatment or EVT, including direct and rescue EVT. The primary outcome was the full distribution of the 90-day modified Rankin Scale (mRS). Inverse probability of treatment weighting (IPTW), multivariable adjustment, and doubly robust analyses were used to address measured baseline imbalance. Results: Among 218 included patients, 128 received medical treatment and 90 underwent EVT, including 56 direct EVT and 34 rescue EVT cases. The median 90-day mRS score was 2 in the medical group and 1 in the EVT group. EVT was associated with a favorable ordinal mRS shift in the IPTW-weighted model (common odds ratio [OR], 1.69; 95% confidence interval [CI], 1.02-2.80; Conclusions: In patients with minor ischemic stroke caused by severe intracranial stenosis or occlusion, EVT was associated with more favorable early neurological and 90-day functional outcomes after adjustment for measured confounding. Collateral status and ischemic penumbra may provide prognostic information, but their role in imaging-informed treatment selection requires prospective validation.
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