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Introduction Acute ischemic stroke (AIS) outcomes remain unpredictable even after successful mechanical thrombectomy (MT). Interleukin-6 (IL-6) and neuron-specific enolase (NSE) are emerging prognostic biomarkers, but their role in MT-treated patients is not well defined.Aim of Study To assess the prognostic value of plasma IL-6 and NSE levels for predicting outcomes and complications in AIS patients undergoing MT.Method A prospective cohort of 70 patients with acute large-vessel occlusion treated with MT was studied. The cohort included 44men (63%) and 26women (37%), aged 38–80 years (mean age: 65.3±9.4 years). Stroke severity was assessed using the NIH Stroke Scale (NIHSS, 8–23 points), and functional outcomes at discharge were evaluated using the modified Rankin Scale (mRS), with 0–3 considered favorable and 4–6 unfavorable. Plasma IL-6 and NSE levels were measured via enzyme-linked immunosorbent assay on days 1 and 7 following stroke.Abstract A252 Table 1Results Patients with NIHSS>15 had elevated IL-6 (day1_13.1±0.9pg/mL vs. 8.5±0.7pg/mL; day7_26.4±3.2 pg/mL vs. 9.8±1.2pg/mL, p<0.01) and NSE (day7_6.6±0.6 µg/L vs. 3.4±0.2µg/L, p<0.01) levels. Patients with poor outcomes had significantly higher IL-6 (13.6±1.0pg/mL vs. 9.0±0.7 pg/mL) and NSE levels (7.1±0.7µg/L vs. 3.7±0.3µg/L, p<0.01). Patients with hemorrhagic transformation exhibited elevated biomarker levels compared to those without transformation: IL-6 (27.5±4.4pg/mL vs. 15.0±2.1pg/mL) and NSE (day7_7.8±0.8µg/L vs. 4.0±0.3µg/L, p<0.01).Abstract A252 Table 2Conclusion Elevated IL-6 and NSE levels are strong predictors of poor outcomes and hemorrhagic transformation after MT in AIS, potentially improving early clinical decision-making and outcome prediction.Conflict of Interest No