>>58327206It's a bootstrap paradox. It's like that futurama episode where fry becomes his own grandfather.
You can sort of conceptualize it as the idea that there's an "original" timeline where she dies, and another timeline with a loop in it where akane lives. So the timeline we see in the game is the one where she's already saved, and she basically has to create the future she saw in order to ensure the timeline stays on course.
Fun fact: that's why she has a fever in some of the routes. She gets a fever in the bad routes, where everyone dies and they don't save her, hence she shouldn't exist in those timelines, hence her fever.