Sex Differences in Screening for Large Vessel Occlusion and Thrombectomy: A Population-Based Cohort Study.

Authors

Yasodara P S Siddharthan, Moira K Kapral, Jiming Fang, Peter C Austin, Anahita Carbonneau, Michael D Hill, Albert Jin, Jennifer Mandzia, Frank L Silver, Amy Y X Yu, SMART-EVT Investigators

Published in

Stroke. Jul 10, 2026. Epub Jul 10, 2026.

Abstract

Population-based sex differences in large vessel occlusion (LVO) screening and thrombectomy use for acute ischemic stroke are not well understood. We compared the detection of LVO, thrombectomy use, and long-term clinical outcomes in female versus male patients with cerebral ischemia in Ontario, Canada.
This retrospective cohort study used data from the Ontario Stroke Registry linked with health administrative data. We included adult patients hospitalized for cerebral ischemia within the first 24 hours of last seen normal time during 2 fiscal years (2019/2020 and 2022/2023). We used modified Poisson regression models to evaluate sex differences in intracranial neurovascular imaging, thrombolysis, or thrombectomy. Among patients with LVO, we used Cox proportional hazard and cause-specific hazard models to compare female versus male long-term mortality, readmission, or nursing home admission until 2025, stratified by thrombectomy treatment.
Among 16 935 eligible patients (47% females; median age, 76 [interquartile range, 65-84] years), females were less likely than males to receive intracranial neurovascular imaging (83.6% female versus 87.8% male; P<0.01). Among those who underwent imaging, 19.3% of females had an LVO compared with 15.9% of males (P<0.01). Thrombectomy use was higher in females than males in the overall cohort (adjusted relative risk, 1.08 [1.01-1.16]), but, once restricted to those with LVO, thrombectomy use was similar (adjusted relative risk, 0.98 [0.93-1.03]). Adjusted hazard of the composite outcome was lower in female patients with LVO treated with thrombectomy compared with their male counterparts (adjusted hazard ratio, 0.88 [0.77-0.99]).
Female patients with acute cerebral ischemia were less likely than male patients to receive intracranial neurovascular imaging but more likely to have an LVO, and long-term mortality was lower in females with LVO treated with thrombectomy. Stroke outcomes' research must account for neurovascular imaging and LVO status to accurately identify sex-based disparities in stroke care and outcomes.

PMID:
42427338
Bibliographic data and abstract were imported from PubMed on 10 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.