Journal of Clinical Neuroscience · May 24, 2025

Skeletal muscle quantity predicts short-term outcomes after endovascular thrombectomy for acute stroke due to large-vessel occlusion of the anterior circulation

By Honma K, Ogino T, Nagase M et al.

OBJECTIVE: Endovascular thrombectomy (EVT) is an essential treatment for large vessel occlusion (LVO) stroke, with expanding indications, including elderly patients and those with extensive ischemic regions. Skeletal muscle mass, a component of frailty, is gaining attention as a potential predictor of EVT outcomes. This study explored the relationship between skeletal muscle mass, assessed by bioelectrical impedance analysis (BIA), and short-term functional prognosis in EVT-treated LVO of anterior-circulation stroke. METHODS: This cohort study included 151 patients who underwent EVT for anterior-circulation LVO between July 2020 and January 2025. Skeletal muscle mass index (SMI) was measured using BIA within 72 h of admission. Functional outcomes were evaluated using the Functional Independence Measure (FIM) at discharge. Multiple regression analysis was performed to identify predictors of FIM, adjusting for age, NIHSS, ASPECTS, mTICI, pre-mRS, and other clinical variables. RESULTS: In multiple regression models, low SMI was independently associated with lower FIM scores at discharge (β = - 10.255, P = 0.013), alongside age (β = - 0.925, P < 0.001), NIHSS on admission (β = -1.506, P < 0.001), mTICI (β = 7.168, P = 0.027), symptomatic intracranial hemorrhage (β = - 2.982, P = 0.010), and pre-mRS (β = - 5.424, P = 0.030). Logistic regression revealed that older age (odds ratio [OR], 1.088; 95 % confidence interval [95 % CI], 1.040-1.139), higher NIHSS (OR, 1.065; 95 % CI, 1.002-1.132), and lower GNRI (OR, 0.925; 95 % CI, 0.886-0.965) were significantly associated with low skeletal muscle mass during admission. CONCLUSION: This study highlights the role of skeletal muscle mass as an independent predictor of short-term prognosis after EVT. BIA-based assessments offer a novel approach to evaluating treatment responsiveness. Enhancing skeletal muscle mass may represent a modifiable factor to improve EVT outcomes, emphasizing the need for further research to validate these findings and explore long-term effects.

doi.org/10.1016/j.jocn.2025.111345Open accessPubMed 40414020Biomarkers