Temporal muscle thickness and clinical outcomes after thrombectomy for internal carotid artery occlusion

Abstract

Objectives: Although endovascular thrombectomy (EVT) can help achieve enhanced functional recovery following anterior circulation large-vessel occlusion (ACLVO) stroke, some patients exhibit poor functional outcomes. We assessed the influence of temporal muscle thickness (TMT) on the functional status after 3 months in individuals with ACLVO stroke treated with EVT.

Methods: This retrospective study analysed adult patients with ACLVO stroke who had undergone EVT between August 2017 and July 2023. We collected clinical, radiological, and laboratory data. The primary functional outcome was the modified Rankin scale (mRS) score 3 months after EVT, and the patients were categorised accordingly into unfavorable (mRS 3–6) and favorable (mRS 0–2) outcome groups.

Results: Overall, 96 patients (mean age: 69.5 years; 58% men; admission NIHSS: 18.3±5.5) were enrolled. At 3-month follow-up, 74 (77.1%) patients experienced unfavorable functional outcomes. The mean TMT was significantly lower in the unfavorable outcome group compared to the favorable outcome group (5.32 ± 1.90 mm vs. 6.66 ± 1.51 mm, P = .003). In multivariate analysis, thinner TMT and higher NIHSS at 24-36 h post-EVT were independently associated with unfavorable 3-month functional outcomes. Subgroup analyses revealed that TMT was significantly associated with unfavorable outcomes in elderly patients (age ≥70 years, P = .044), those with Internal Carotid Artery (ICA) occlusion (P = .005), particularly in ICA occlusion patients achieving successful recanalization (P = .034).

Conclusions: Thinner TMT was independently associated with unfavorable 3-month functional outcomes in patients with acute ICA occlusion who had undergone EVT, suggesting its potential value as a prognostic marker.