Symbolic brain image representing stroke recovery and hope.

Stroke Recovery: What to Know About Thrombectomy for Patients with Pre-existing Disabilities

Theo Raines in Health & Wellness December 2025 • 4 min read.

"New research sheds light on the effectiveness of thrombectomy in stroke patients with pre-existing disabilities, offering hope and informing treatment decisions."

Stroke is a leading cause of long-term disability, but advancements in treatment offer hope for improved outcomes. One such advancement is mechanical thrombectomy, a procedure to remove blood clots from the brain. While thrombectomy has become a standard treatment for many stroke patients, its effectiveness in individuals with pre-existing disabilities has been less clear.

The modified Rankin Scale (mRS) is a common tool used to assess the degree of disability after a stroke. It ranges from 0 (no symptoms) to 6 (death). Patients with pre-existing disabilities, often indicated by mRS scores of 3 (moderate disability) or 4 (moderately severe disability), have historically been excluded from many clinical trials evaluating thrombectomy. This exclusion has left a gap in our understanding of how effective this treatment is for those who may already face daily challenges.

A recent study published in the American Journal of Neuroradiology aimed to address this gap by analyzing the outcomes of thrombectomy in patients with pre-stroke mRS scores of 3 and 4. This article will break down the study's findings, explore their implications, and provide insights for patients, families, and healthcare professionals navigating stroke recovery.

Understanding the Study: Key Findings on Thrombectomy Outcomes

Symbolic brain image representing stroke recovery and hope.

The study, conducted at Heidelberg University Hospital in Germany, retrospectively analyzed data from 136 patients who underwent mechanical thrombectomy for anterior circulation stroke between January 2009 and November 2017. All patients had pre-stroke mRS scores of 3 or 4. Researchers defined a 'good outcome' as the patient returning to their pre-stroke mRS score at 90 days post-treatment.

Here’s a summary of the key findings:

Recovery Rates: Approximately 21% of patients achieved a good outcome, meaning they returned to their pre-stroke level of disability.
mRS Scores: 81.6% of patients had a premorbid mRS of 3, while 18.4% had a premorbid mRS of 4.
Outcome Comparison: 24.0% of patients with premorbid mRS 4 achieved clinical recovery compared with 20.7% of patients with premorbid mRS 3.
Mortality: Hospital mortality and mortality at 90 days was markedly higher in patients with premorbid mRS 4.
Predictive Factors: Low initial NIHSS scores, high ASPECTS scores, and successful recanalization (TICI 2b-3) were identified as independent predictors of good outcome.

In simpler terms, the study found that while the overall recovery rate wasn't high, about one in five patients with pre-existing moderate to moderately severe disabilities experienced a return to their previous functional status after thrombectomy. The study also highlighted factors that can help predict which patients are more likely to benefit from the procedure.

The Path Forward: Optimism and Informed Decision-Making in Stroke Care

This study offers valuable insights for stroke patients with pre-existing disabilities and their families. While thrombectomy may not guarantee a full recovery, it does offer a chance for improvement in some cases. The identification of predictive factors can help healthcare professionals make more informed decisions about who is most likely to benefit from the procedure. More research is needed, including randomized controlled trials, to further clarify the role of thrombectomy in this patient population and refine treatment strategies for optimal outcomes.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.3174/ajnr.a5920, Alternate LINK

Title: Clinical Outcome After Thrombectomy In Patients With Stroke With Premorbid Modified Rankin Scale Scores Of 3 And 4: A Cohort Study With 136 Patients

Subject: Neurology (clinical)

Journal: American Journal of Neuroradiology

Publisher: American Society of Neuroradiology (ASNR)

Authors: F. Seker, J. Pfaff, S. Schönenberger, C. Herweh, S. Nagel, P.A. Ringleb, M. Bendszus, M.A. Möhlenbruch

Published: 2018-12-20

Everything You Need To Know

What is mechanical thrombectomy, and why is it relevant for stroke patients with pre-existing disabilities?

Mechanical thrombectomy is a procedure used to remove blood clots from the brain, a standard treatment for many stroke patients. Its relevance for individuals with pre-existing disabilities, indicated by modified Rankin Scale (mRS) scores of 3 or 4, lies in the need to understand its effectiveness for those who already face daily challenges. Historically, this group has been excluded from many clinical trials, creating a gap in knowledge about its benefits for them.

How does the modified Rankin Scale (mRS) play a role in assessing stroke patients, particularly those considered for thrombectomy?

The modified Rankin Scale (mRS) is a common tool used to assess the degree of disability after a stroke, ranging from 0 (no symptoms) to 6 (death). Patients with pre-existing disabilities often have mRS scores of 3 (moderate disability) or 4 (moderately severe disability). These scores help healthcare professionals evaluate a patient's initial condition and measure recovery outcomes post-thrombectomy, making it crucial for determining the procedure's impact.

What were the key findings of the study regarding thrombectomy outcomes for stroke patients with pre-stroke modified Rankin Scale (mRS) scores of 3 and 4?

The study's key findings indicate that approximately 21% of patients with pre-stroke modified Rankin Scale (mRS) scores of 3 or 4 achieved a good outcome, defined as returning to their pre-stroke level of disability at 90 days post-treatment. Further, 24% of patients with premorbid mRS of 4 achieved clinical recovery compared with 20.7% of patients with premorbid mRS of 3. The study also identified that low initial NIHSS scores, high ASPECTS scores, and successful recanalization (TICI 2b-3) were independent predictors of a good outcome.

The study mentions NIHSS scores, ASPECTS scores and TICI scores, can you briefly explain these and why these are predictive factors of a good outcome?

The NIHSS (National Institutes of Health Stroke Scale) score assesses the severity of stroke symptoms; a low initial score suggests less severe damage, increasing the likelihood of a better outcome with thrombectomy. The ASPECTS (Alberta Stroke Program Early CT Score) score evaluates the extent of early ischemic changes on brain CT scans; a high score indicates less damage, improving the chances of successful recovery. Successful recanalization, measured by TICI (Thrombolysis in Cerebral Infarction) grades 2b-3, means that blood flow has been restored to the affected area of the brain, which is critical for recovery. Therefore, low NIHSS, high ASPECTS, and successful TICI scores mean there is less initial damage and better restoration of blood flow. This suggests the brain has a greater capacity to recover its original functional ability after the thrombectomy procedure.

What are the implications of the study's findings for stroke patients with pre-existing disabilities and how might treatment strategies be refined?

The study suggests that while thrombectomy may not guarantee full recovery, it offers a chance for improvement for some stroke patients with pre-existing disabilities, especially those with low initial NIHSS scores, high ASPECTS scores, and successful recanalization (TICI 2b-3). Treatment strategies can be refined by using these predictive factors to make more informed decisions about which patients are most likely to benefit. The study highlights the need for more research, including randomized controlled trials, to further clarify the role of thrombectomy in this patient population and optimize treatment approaches.