Comparison of short-and long-term prognostic differences and validation of clinical prediction models between two types of mechanical thrombectomy in patients with acute ischemic stroke aged 75 years and above.

Background: As the global population ages, the incidence of acute ischemic stroke (AIS) among individuals aged 75 years and older is steadily increasing. Mechanical thrombectomy (MT) has become a standard treatment for AIS, with two commonly employed approaches: bridging thrombectomy (BT) and direct mechanical thrombectomy (DMT). However, the efficacy and safety of these strategies in elderly patients remain inconclusive. Methods: This single-center retrospective study included AIS patients aged 75 years and older who underwent BT or DMT at Liuan City Hospital of Traditional Chinese Medicine, affiliated with Anhui University of Traditional Chinese Medicine, between December 2020 and August 2024. After propensity score matching (PSM), patients were compared in terms of neurological outcomes (NIHSS, mRS), inflammatory markers (CRP, NLR, SII, SIRI), and complication rates at 24 h, 7 days, and 90 days post-treatment. A predictive model for 90-day functional outcome was developed using univariate and multivariate regression analyses and evaluated for performance. Results: A total of 87 patients were enrolled, and CRP levels on day 7 after treatment were significantly higher in the BT group than in the DMT group ( Conclusion: In AIS patients aged 75 years and older, both BT and DMT yielded comparable short- and long-term neurological outcomes. Onset Puncture Time, Postoperative NIHSS at 24 h and CRP at 7 days were key prognostic factors. The developed model may serve as a reliable tool for individualized prognosis assessment and optimization of treatment strategies in elderly stroke patients.