Background: Large core acute ischemic stroke (AIS) caused by large vessel occlusion (LVO) is associated with high rates of disability despite mechanical thrombectomy (MT) treatment. Recent studies suggest that prolonged venous transit (PVT) may indicate impaired venous drainage, influencing functional outcomes. However, its prognostic value in large core AIS-LVO patients remains unclear. Methods: We conducted a retrospective cohort study using data from consecutive patients with AIS-LVO and large ischemic core volumes (ASPECTS 6s) and large core volumes (rCBF <30%). Other predictors included older age (adjusted OR 1.07, 95% CI 1.02 to 1.11, P=0.003), higher admission NIHSS (adjusted OR 1.16, 95% 89 CI 1.05 to 1.29, P=0.005), and larger rCBF <30% volume (adjusted OR 1.02, 95% CI 1.00 to 1.04, P=0.032). Conclusions: PVT is independently associated with unfavorable outcomes in patients with large core AIS-LVO. These findings suggest PVT may serve as a prognostic marker, warranting further investigation in larger prospective studies to guide treatment decisions in this high-risk population.
Musmar et al. (Thu,) studied this question.