{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T02:32:25Z","timestamp":1768876345416,"version":"3.49.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The benefit of endovascular treatment (EVT) in patients with acute ischemic stroke due to large vessel occlusion is now well established. EVT is highly effective for treating embolic occlusions; however, there remains ongoing debate regarding the optimal management of underlying intracranial atherosclerotic disease (ICAD). Current approaches often involve a combination of best medical therapy and mechanical rescue strategies, such as intracranial angioplasty or stenting. In this study, we aimed to compare EVT outcomes between patients with ICAD-related strokes and those with cardioembolic strokes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>The study was designed retrospectively. Data of patients admitted to the stroke center were analyzed. The results of the ICAD group were compared with the cardioembolic stroke group. Demographic characteristics, comorbidities, medications, IV rtPA use before EVT, contraindications, radiologic imaging results, and mechanical thrombectomy results were evaluated. Modified Rankin Score (mRS) results at discharge and 3\u202fmonths were analyzed. At the end of 3\u202fmonths, those with mRS 0\u20132 were included in the good outcome group, and those with mRS 3\u20136 were included in the poor outcome group. In this study, propensity score matching (PSM) was implemented. The logistic regression model was used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 349 patients were included, with 12% classified in the ICAD group and 88% in the cardioembolic group. Through PSM, 40 matched patients were successfully identified in the cardioembolism group, corresponding to 42 patients in the ICAD group. During EVT, dissection (OR: 1.105, 95% CI: 1.002\u20131.219) and reocclusion after EVT (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.002) rates were statistically significant in the ICAD group. No significant difference in the rate of symptomatic intracerebral hemorrhage (sICH) was observed between the groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.892). The ICAD group showed higher rates of failed recanalization (mTICI 0\u20132b) and worse 3-month mRS scores (mRS 3\u20136) compared to the cardioembolic group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this comparative study of EVT outcomes in ICAD-related and cardioembolic strokes, no significant difference was seen in the rate of post-procedural hemorrhagic complications. It was observed that 3-month poor outcome rates were higher in acute stroke patients with ICAD compared to cardioembolic strokes. We revealed that patients with ICAD presenting with acute ischemic stroke demonstrated higher rates of complications (dissection) and lower recanalization rates following EVT. These results highlight the need for tailored therapeutic strategies and careful procedural planning in patients with ICAD to improve clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1660804","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T14:01:38Z","timestamp":1768831298000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of endovascular treatment outcomes in stroke patients with cardioembolic or intracranial atherosclerosis-predisposed large vessel occlusion"],"prefix":"10.3389","volume":"16","author":[{"given":"Fergane","family":"Mehmedova","sequence":"first","affiliation":[{"name":"Basaksehir Cam and Sakura City Hospital","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zehra Uysal","family":"Kocaba\u015f","sequence":"additional","affiliation":[{"name":"Department of Neurology, Eskisehir Osmangazi University","place":["Eskisehir, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00d6zlem","family":"Ayka\u00e7","sequence":"additional","affiliation":[{"name":"Department of Neurology, Eskisehir Osmangazi University","place":["Eskisehir, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hasan","family":"Bay\u0131nd\u0131r","sequence":"additional","affiliation":[{"name":"Neurology Clinic, Ankara City Hospital","place":["Ankara, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atilla Ozcan","family":"Ozdemir","sequence":"additional","affiliation":[{"name":"Department of Neurology, Eskisehir Osmangazi University","place":["Eskisehir, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"3","DOI":"10.5853\/jos.2021.01375","article-title":"Endovascular treatment of large vessel occlusion strokes due to intracranial atherosclerotic disease","volume":"24","author":"Lee","year":"2022","journal-title":"J Stroke"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"143","DOI":"10.5853\/jos.2017.00626","article-title":"Diagnostic and therapeutic strategies for acute intracranial atherosclerosis-related occlusions","volume":"19","author":"Lee","year":"2017","journal-title":"J Stroke"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"394","DOI":"10.5853\/jos.2018.01627","article-title":"Prognosis of acute intracranial atherosclerosis- related occlusion after endovascular treatment","volume":"20","author":"Lee","year":"2018","journal-title":"J Stroke"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"107232","DOI":"10.1016\/j.jstrokecerebrovasdis.2023.107232","article-title":"Stent reconstruction in intracranial atherosclerotic disease related acute ischemic stroke results in high revascularization rates","volume":"32","author":"Thut","year":"2023","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2072","DOI":"10.3174\/ajnr.A4844","article-title":"Effect of intracranial atherosclerotic disease on endovascular treatment for patients with acute vertebrobasilar occlusion","volume":"37","author":"Kim","year":"2016","journal-title":"AJNR Am J Neuroradiol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"2074","DOI":"10.1016\/j.jstrokecerebrovasdis.2015.05.003","article-title":"Endovascular therapy of cerebral arterial occlusions: intracranial atherosclerosis versus embolism","volume":"24","author":"Lee","year":"2015","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1007\/s00062-020-00899-x","article-title":"Differences in safety and efficacy of endovascular treatment for acute ischemic stroke","volume":"31","author":"Yang","year":"2021","journal-title":"Clin Neuroradiol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"2699","DOI":"10.1161\/STROKEAHA.118.022327","article-title":"Outcomes of endovascular treatment for acute intracranial atherosclerosis-related large vessel occlusion","volume":"49","author":"Baek","year":"2018","journal-title":"Stroke"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/1756286421999017","article-title":"Endovascular therapy in patients with large vessel occlusion due to cardioembolism versus large-artery atherosclerosis","volume":"14","author":"Zotter","year":"2021","journal-title":"Ther Adv Neurol Disord"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1910","DOI":"10.1056\/NEJMoa2030297","article-title":"Endovascular therapy for stroke due to basilar-artery occlusion","volume":"384","author":"Langezaal","year":"2021","journal-title":"N Engl J Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1174","DOI":"10.1136\/neurintsurg-2018-014516","article-title":"Mechanical thrombectomy for basilar artery occlusion: efficacy, outcomes, and futile recanalization in comparison with the anterior circulation","volume":"11","author":"Meinel","year":"2019","journal-title":"J Neurointerterv Surg"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1388","DOI":"10.1227\/neu.0000000000003035","article-title":"Thrombectomy outcomes in acute basilar artery occlusions due to intracranial atherosclerotic disease","volume":"95","author":"Mierzwa","year":"2024","journal-title":"Neurosurgery"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"106538","DOI":"10.1016\/j.clineuro.2021.106538","article-title":"Efficacy and safety of rescue angioplasty and\/or stenting for acute large artery occlusion with underlying intracranial atherosclerosis: a systematic review and meta-analysis","volume":"203","author":"Zhang","year":"2021","journal-title":"Clin Neurol Neurosurg"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1159\/000362435","article-title":"Instant reocclusion following mechanical thrombectomy of in situ thromboocclusion and the role of low-dose intra-arterial tirofiban","volume":"37","author":"Kang","year":"2014","journal-title":"Cerebrovasc Dis"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"739","DOI":"10.3348\/kjr.2018.0809","article-title":"Current opinion on endovascular therapy for emergent large vessel occlusion due to underlying intracranial atherosclerotic stenosis","volume":"20","author":"Kang","year":"2019","journal-title":"Korean J Radiol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"105960","DOI":"10.1016\/j.jstrokecerebrovasdis.2021","article-title":"Endovascular therapy for acute ischemic stroke in patients with large-vessel occlusion due to to atherosclerotic stenosis","volume":"30","author":"Shirakawa","year":"2021","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1159\/000323610","article-title":"Clinical and radiological outcomes after intracranial atherosclerotic stroke: a comprehensive approach comparing stroke subtypes","volume":"31","author":"Kim","year":"2011","journal-title":"Cerebrovasc Dis"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1177\/23969873221101285","article-title":"Endovascular treatment for acute basilar artery occlusion due to different stroke etiologies of large artery atherosclerosis and cardioembolism","volume":"7","author":"Liu","year":"2022","journal-title":"Eur Stroke J"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"539","DOI":"10.3390\/brainsci13040539","article-title":"Collateral circulation and BNP in predicting outcome of acute ischemic stroke patients with atherosclerotic versus cardioembolic cerebral large- vessel occlusion who underwent endovascular treatment","volume":"13","author":"Cao","year":"2023","journal-title":"Brain Sci"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"15910199251361304","DOI":"10.1177\/15910199251361304","article-title":"Comparative analysis of outcome-associated factors following endovascular treatment for intracranial atherosclerotic disease and cardioembolism: a subanalysis of the K-NET registry","volume":"1","author":"Ueda","year":"2025","journal-title":"Interv Neuroradiol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1227\/NEU.0000000000000694","article-title":"Endovascular treatment and the outcomes of atherosclerotic intracranial stenosis in patients with hyperacute stroke","volume":"76","author":"Yoon","year":"2015","journal-title":"Neurosurgery"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"e001378","DOI":"10.1161\/SVIN.124.001378","article-title":"Prevalence and angiographic outcomes of rescue intracranial stenting in large vessel occlusion following stroke thrombectomy \u2013 STRATIS","volume":"5","author":"Saber","year":"2025","journal-title":"Stroke Vasc Interv Neurol"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1660804\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T14:01:39Z","timestamp":1768831299000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1660804\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,19]]},"references-count":22,"alternative-id":["10.3389\/fneur.2025.1660804"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1660804","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,19]]},"article-number":"1660804"}}