{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T18:23:32Z","timestamp":1757615012298,"version":"3.44.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"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><jats:title>Background<\/jats:title><jats:p>The clinical benefit of mechanical thrombectomy (MT) for anterior circulation emergency large vessel occlusion (ELVO) in patients presenting with a mild National Institutes of Health Stroke Scale score (&amp;lt;6) remains uncertain. We aimed to assess the efficacy and safety of MT in this patient population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled individuals presenting with mild stroke attributable to anterior circulation LVO from three stroke centers between March 2020 and June 2024. The primary endpoint was an excellent 90-day outcome, defined as a modified Rankin Scale (mRS) score of 0\u20131. Functional independence at day 90 (mRS 0\u20132) was considered the secondary endpoint. Safety endpoints consisted of symptomatic intracranial hemorrhage (sICH) and all-cause mortality within 90 days. Multivariable logistic regression with inverse probability of treatment weighting (IPTW) was applied to examine the association between MT and clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 140 individuals with mELVO were selected for analysis, receiving either MT [<jats:italic>n<\/jats:italic> = 48; 35 males; mean age: 59.9 years; NIHSS median: 4 (IQR 2\u20135)] or medical management (MM) [<jats:italic>n<\/jats:italic> = 92; 62 males; mean age: 61.9 years; NIHSS median: 3 (IQR 1\u20134)]. No statistically significant differences were observed between the MT and MM groups in excellent outcome (aOR = 0.93; 95% CI, 0.41\u20132.11), functional independence (aOR = 2.14; 95% CI, 0.77\u20135.91), symptomatic intracranial hemorrhage (aOR = 1.63; 95% CI, 0.37\u20137.14), or mortality (aOR = 0.56; 95% CI, 0.02\u201320.94). The results remained consistent after IPTW adjustment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Among patients with mELVO, MT was not associated with significantly different outcomes compared to MM. Further investigation through randomized controlled trials is warranted.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1668704","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T12:25:08Z","timestamp":1757075108000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Mechanical thrombectomy for mild stroke with anterior circulation large vessel occlusion: a multicenter cohort study"],"prefix":"10.3389","volume":"16","author":[{"given":"Gaopan","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingfan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siyu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manhe","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiongfei","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2285","DOI":"10.1056\/NEJMoa1415061","article-title":"Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke","volume":"372","author":"Saver","year":"2015","journal-title":"N Engl J Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1019","DOI":"10.1056\/NEJMoa1414905","article-title":"Randomized assessment of rapid endovascular treatment of ischemic stroke","volume":"372","author":"Goyal","year":"2015","journal-title":"N Engl J Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2296","DOI":"10.1056\/NEJMoa1503780","article-title":"Thrombectomy within 8 hours after symptom onset in ischemic stroke","volume":"372","author":"Jovin","year":"2015","journal-title":"N Engl J Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1056\/NEJMoa1713973","article-title":"Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging","volume":"378","author":"Albers","year":"2018","journal-title":"N Engl J Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e344","DOI":"10.1161\/STR.0000000000000211","article-title":"Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"50","author":"Powers","year":"2019","journal-title":"Stroke."},{"key":"B6","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1177\/2396987319832140","article-title":"European Stroke Organisation (ESO) - 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