Background: Stroke is a leading cause of global mortality and long-term disability, necessitating advancements in acute therapeutic interventions. Intra-arterial mechanical thrombectomy (IAMT) has emerged as a standard treatment for acute ischemic stroke (AIS) due to large vessel occlusion (LVO). However, the clinical predictors of outcomes in AIS patients requiring neuro-intensive care following IAMT remain inadequately studied. Methods: This study was conducted on 200 AIS patients admitted to a tertiary stroke facility's neuro-intensive care unit (NICU) . All participants underwent IAMT and were monitored for functional recovery using the modified Rankin Scale (mRS). Baseline clinical and demographic data were analyzed using univariate and multivariate logistic regression to identify predictors of favorable outcomes (mRS ≤ 2). Results: Of the 200 patients (median age: 75 years, 55% female), 85% achieved successful recanalization (mTICI 2b/3). First assessment intravenous thrombolysis (IVT) (OR: 3.78; 95% CI: 1.20–11.90) and nasogastric tube (NGT) removal (OR: 3.32; 95% CI: 1.04–10.59) were associated with favorable outcomes, while higher baseline NIHSS scores correlated with poorer outcomes (OR: 0.72 per point increase; 95% CI: 0.61–0.85). advanced age (OR: 0.95; 95% CI: 0.92–0.99), hemorrhagic transformation (OR: 0.30; 95% CI: 0.12–0.83), and baseline NIHSS scores (OR: 0.80 per point increase; 95% CI: 0.74–0.89) predicted poor outcomes, while successful recanalization strongly predicted favorable outcomes (OR: 8.12; 95% CI: 1.75–38.52). Conclusion: While IAMT significantly improves recanalization rates, functional outcomes depend on various clinical and demographic factors. Early IVT administration and post-procedural management, including NGT removal, improve short-term recovery, whereas age, hemorrhagic transformation, and baseline NIHSS scores influence long-term outcomes. These findings underscore the need for individualized care strategies to optimize recovery trajectories in AIS patients requiring intensive care.

Stroke is a leading cause of global mortality and long-term disability