INTRODUCTION: The benefits of thrombectomy for occlusion of M2 segments remain controversial. The aim of this study is to assess thrombectomy's efficacy and safety in patients with M2 segment occlusion and associations between occlusion sites and anatomic variations of M1 division. MATERIALS AND METHODS: A prospective series of 30 patients with acute ischemic stroke (AIS) resulting from M2 segment occlusion of the middle cerebral artery (MCA) who underwent thrombectomy was analyzed. The primary endpoint was assessed by the Extended Treatment in Cerebral Infarction scale (eTICI). The secondary endpoints were the incidence of symptomatic hemorrhagic transformation (sICH), mortality and good functional outcome at three months. RESULTS: The mean patient age was 69.2 years. The mean National Institutes Health Stroke Scale score (NIHSS) upon hospital admission was 16. The recanalization rates were eTICI 2b/3 in 90% and 2c/3 in 60% of the patients. Total recanalization of the M2 branch was achieved in 53% of patients. sICH incidence was 6.6%, the mortality rate was 30%, and a good functional outcome (mRS ≤2) was observed in 50% of the patients. Twenty-seven patients (90%) had a dominant M2 branch and all were occluded. Regarding the site of M2 occlusions, 74% of patients had proximal M2 occlusions. CONCLUSIONS: Thrombectomy appears to be a safe and effective method for the treatment of acute M2 segment occlusions of the MCA. Most of the cases had a dominant M2 branch, and all of them were occluded. Larger studies are needed to verify the benefits of thrombectomy for different settings of M2 occlusions.
INTRODUCTION: The benefits of thrombectomy for occlusion of M2 segments remain controversial. The aim of this study is to assess thrombectomy's efficacy and safety in patients with M2 segment occlusion and associations between occlusion sites and anatomic variations of M1 division. MATERIALS AND METHODS: A prospective series of 30 patients with acute ischemic stroke (AIS) resulting from M2 segment occlusion of the middle cerebral artery (MCA) who underwent thrombectomy was analyzed. The primary endpoint was assessed by the Extended Treatment in Cerebral Infarction scale (eTICI). The secondary endpoints were the incidence of symptomatic hemorrhagic transformation (sICH), mortality and good functional outcome at three months. RESULTS: The mean patient age was 69.2 years. The mean National Institutes Health Stroke Scale score (NIHSS) upon hospital admission was 16. The recanalization rates were eTICI 2b/3 in 90% and 2c/3 in 60% of the patients. Total recanalization of the M2 branch was achieved in 53% of patients. sICH incidence was 6.6%, the mortality rate was 30%, and a good functional outcome (mRS ≤2) was observed in 50% of the patients. Twenty-seven patients (90%) had a dominant M2 branch and all were occluded. Regarding the site of M2 occlusions, 74% of patients had proximal M2 occlusions. CONCLUSIONS: Thrombectomy appears to be a safe and effective method for the treatment of acute M2 segment occlusions of the MCA. Most of the cases had a dominant M2 branch, and all of them were occluded. Larger studies are needed to verify the benefits of thrombectomy for different settings of M2 occlusions.
Authors: Nils H Mueller-Kronast; Osama O Zaidat; Michael T Froehler; Reza Jahan; Mohammad Ali Aziz-Sultan; Richard P Klucznik; Jeffrey L Saver; Frank R Hellinger; Dileep R Yavagal; Tom L Yao; David S Liebeskind; Ashutosh P Jadhav; Rishi Gupta; Ameer E Hassan; Coleman O Martin; Hormozd Bozorgchami; Ritesh Kaushal; Raul G Nogueira; Ravi H Gandhi; Eric C Peterson; Shervin R Dashti; Curtis A Given; Brijesh P Mehta; Vivek Deshmukh; Sidney Starkman; Italo Linfante; Scott H McPherson; Peter Kvamme; Thomas J Grobelny; Muhammad S Hussain; Ike Thacker; Nirav Vora; Peng Roc Chen; Stephen J Monteith; Robert D Ecker; Clemens M Schirmer; Eric Sauvageau; Alex Abou-Chebl; Colin P Derdeyn; Lucian Maidan; Aamir Badruddin; Adnan H Siddiqui; Travis M Dumont; Abdulnasser Alhajeri; M Asif Taqi; Khaled Asi; Jeffrey Carpenter; Alan Boulos; Gaurav Jindal; Ajit S Puri; Rohan Chitale; Eric M Deshaies; David H Robinson; David F Kallmes; Blaise W Baxter; Mouhammad A Jumaa; Peter Sunenshine; Aniel Majjhoo; Joey D English; Shuichi Suzuki; Richard D Fessler; Josser E Delgado Almandoz; Jerry C Martin; Diogo C Haussen Journal: Stroke Date: 2017-08-22 Impact factor: 7.914
Authors: Jeffrey L Saver; Mayank Goyal; Alain Bonafe; Hans-Christoph Diener; Elad I Levy; Vitor M Pereira; Gregory W Albers; Christophe Cognard; David J Cohen; Werner Hacke; Olav Jansen; Tudor G Jovin; Heinrich P Mattle; Raul G Nogueira; Adnan H Siddiqui; Dileep R Yavagal; Blaise W Baxter; Thomas G Devlin; Demetrius K Lopes; Vivek K Reddy; Richard du Mesnil de Rochemont; Oliver C Singer; Reza Jahan Journal: N Engl J Med Date: 2015-04-17 Impact factor: 91.245
Authors: Alan Flores; Alejandro Tomasello; Pere Cardona; M Angeles de Miquel; Meritxell Gomis; Pablo Garcia Bermejo; Victor Obach; Xabi Urra; Joan Martí-Fàbregas; David Cánovas; Jaume Roquer; Sònia Abilleira; Marc Ribó Journal: J Neurointerv Surg Date: 2014-02-27 Impact factor: 5.836
Authors: J M Coutinho; D S Liebeskind; L-A Slater; R G Nogueira; B W Baxter; E I Levy; A H Siddiqui; M Goyal; O O Zaidat; A Davalos; A Bonafé; R Jahan; J Gralla; J L Saver; V M Pereira Journal: AJNR Am J Neuroradiol Date: 2015-11-12 Impact factor: 3.825
Authors: Sunil A Sheth; Konark Malhotra; David S Liebeskind; Conrad W Liang; Albert J Yoo; Reza Jahan; Raul G Nogueira; Vitor Pereira; Jan Gralla; Greg Albers; Mayank Goyal; Jeffrey L Saver Journal: Interv Neurol Date: 2018-09-03
Authors: Ansaar T Rai; Jennifer R Domico; Chelsea Buseman; Abdul R Tarabishy; Daniel Fulks; Noelle Lucke-Wold; SoHyun Boo; Jeffrey S Carpenter Journal: J Neurointerv Surg Date: 2017-09-28 Impact factor: 5.836
Authors: Hanna Styczen; Volker Maus; Amélie C Hesse; Lukas Goertz; Sebastian Fischer; Christian Riedel; Michael Forsting; Alexander Radbruch; Daniel Behme Journal: Interv Neuroradiol Date: 2020-04-27 Impact factor: 1.610
Authors: Jan Harsany; Jozef Haring; Matus Hoferica; Miroslav Mako; Pavol Janega; Georgi Krastev; Andrej Klepanec Journal: Interv Neuroradiol Date: 2020-05-12 Impact factor: 1.610