Abstract Number: Esoc2026a1341 Sex-Based Differences in Process Measures and Outcomes After Endovascular Thrombectomy for Large Vessel Occlusion Stroke

Abstract Background and aims The existence of sex-based differences in outcomes after endovascular thrombectomy (EVT) remains controversial. We aimed to evaluate whether sex is independently associated with process measures and outcomes after EVT in a real-world cohort. Methods We conducted a retrospective cohort study of adult patients with acute ischemic stroke treated with EVT at a comprehensive stroke center between January 1, 2022, and June 20, 2023. Baseline characteristics, procedural variables, and outcomes were compared between males and females. The primary outcome was favorable functional outcome at 3–6 months, defined as modified Rankin Scale (mRS) 0–2. Secondary outcomes included workflow metrics, successful reperfusion, EVT technical details, and intracerebral hemorrhage. Multivariable logistic regression was used to evaluate the independent association between sex and outcome. Results Among 514 patients, 247 (48%) were male and 267 (52%) female. Females were older (p 0.001), had a higher prevalence of atrial fibrillation (p 0.001), and lower rates of tandem lesions (p 0.001) and basilar artery occlusion (p = 0.03). Favorable functional outcome was achieved in 44% of the overall cohort, with no significant difference between sexes. EVT techniques, workflow times, successful reperfusion rates, and periprocedural complications, including symptomatic intracranial hemorrhage, were comparable between groups. After adjustment for age and stroke severity, sex was not independently associated with functional outcome at 90 days. Conclusions In this cohort, functional outcomes did not differ between males and females after adjustment for baseline clinical differences. This is consistent with recent literature reporting comparable functional and radiological outcomes after EVT between sexes. Conflict of interest nothing to disclose