Effect of endovascular thrombectomy on cognitive function in patients with acute ischemic stroke

According to a recent study, endovascular therapy (EVT) yielded positive results in global analyses of cognitive benefit and across five separate cognitive tests. These findings provide new evidence regarding the influence of EVT on cognition and provide further support for the overall advantages of EVT treatment. This study’s results were published in the Neurology journal.

The ESCAPE randomized trial data were analyzed, which involved 315 patients. Among them, 165 were assigned to EVT and 150 to the control group. Cognitive evaluations were performed 90 days post-stroke using the Sunnybrook Neglect Assessment Procedure (SNAP), Montreal Cognitive Assessment (MoCA), Boston Naming Test (BNT), Trail-making test A (Trails A), and Trail-making test B (Trails B). Logistic regression was used to investigate the connection between EVT and favorable cognitive outcomes on the 5 tests separately, while adjusting for demographic and clinical variables. Generalized estimating equations and ordinal regression were used to determine the likelihood of positive outcomes with EVT on overall cognitive function, incorporating all 5 tests. To examine the connection between final infarct volume (FIV) and cognitive outcome, FIV was incorporated into the models.

There was a greater likelihood of achieving a positive outcome with EVT for MoCA (adjusted odds ratio [aOR] 2.32), BNT (aOR 2.33), SNAP (aOR 3.85), trails A (aOR 3.50), and trails B (aOR 2.56). EVT also showed higher odds of favorable outcome in terms of global binary (aOR 2.57) and ordinal analyses (aOR 2.83) of cognitive function. After incorporating FIV into the models, both EVT and FIV were found to be significantly associated with cognitive outcome. Additionally, there was a significant correlation between global cognitive performance and mRS at day 90 (r = -0.78, p < 0.001), with the most substantial reductions in favorable cognitive outcome observed between mRS scores 4 and 5, as well as between mRS scores 2 and 3.

Thus, it can be concluded that EVT produced favorable outcomes in global analyses of cognitive benefit and in five distinct cognitive assessments.