Sex-dependent outcomes of recanalization-treated acute ischemic stroke patients at Shamir (Assaf Harofeh) medical center, Israel, 2011–2020

Itzhak Kimiagar, Fikri Khiri, Sigal Tal, Ronen Levite, Shani Kalmanovich-Avnery, Rina Aroesty, Sarah Bhonkar, Jochay Wainstein, Gilad Kenan, Nitai Shimon, Ahmed Khadija, Neta Agajani, Sofia Galinskaya, Sharon Wolfson, Zoya Haitov, Eran Kalmanovich, Daniel Trotsky, Eduard Ilgiyaev, Carmel Armon*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background/objectives: Sex-based differences in incidence, etiologies, severity and recanalization treatment outcomes of patients with acute ischemic stroke (AIS) have been studied extensively. We set out to determine if there were sex-based differences in outcomes among AIS patients who received recanalization treatments at Shamir (Assaf Harofeh) Medical Center (SMC), Israel, between 2011 and 2020. Methods: This was a single-center, retrospective chart review. The primary analysis compared outcomes for men and women, overall and stratifying by disease severity. We compared also demographics, risk factors and workflow data. Results: Eight hundred and eleven patients received recanalization treatment between 2011 and 2020: 472 (58.1%) men and 339 (41.8%) women. Mean age, NIHSS score and proportion with an NIHSS score ≥ 6 were higher for women. Cerebrovascular risk factors were more prevalent in women, particularly atrial fibrillation, except that current smoking was more prevalent in men. Six hundred and twenty patients (78.1%) were treated with TPA alone, 89 (11.2%) with TPA and endovascular treatment (EVT), and 85 (10.7%) with EVT alone. Fifty percent of patients were discharged home, 41% to a rehabilitation hospital or nursing home, and 9% did not survive. Twenty-four patients (3%) sustained symptomatic bleeds. Outcomes were worse in patients with NIHSS score ≥ 6. Outcomes did not differ by sex. Conclusions: While treated women presented with more severe AIS and more risk factors, we did not find significant sex-related differences in outcomes. Meticulous adherence to risk factor modification remains the best strategy to reduce stroke incidence, morbidity, and mortality in women and in men.

Original languageEnglish
Article number120674
JournalJournal of the Neurological Sciences
StatePublished - 15 Jul 2023


  • Acute ischemic stroke
  • IV TPA
  • Recanalization treatments
  • Sex-dependent outcomes
  • Thrombectomy


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