Literature DB >> 32397859

Aspiration thrombectomy as the first-line treatment of M2 occlusions.

Jan Harsany1, Jozef Haring2, Matus Hoferica1, Miroslav Mako2, Pavol Janega3, Georgi Krastev2, Andrej Klepanec1.   

Abstract

PURPOSE: The aim of the present study was (i) to evaluate the safety and efficacy of aspiration thrombectomy in patients with M2 occlusions and (ii) to compare outcome of treatment of occlusion of different M2 segments.
MATERIALS AND METHODS: Between March 2016 and June 2019, 82 patients with acute ischemic stroke and isolated M2 occlusions were treated in cerebrovascular stroke center with aspiration thrombectomy as the first-line treatment. Functional outcomes of patients with different types of M2 occlusions were statistically compared. Multivariable logistic regression analysis was performed to determine the factors associated with good clinical outcome.
RESULTS: The mean age was 71.9 ± 13.4 years, 47.6% were men. Aspiration thrombectomy alone was utilized in 72.5% of patients, with 27.5% of patients being treated with a combination of aspiration thrombectomy and stent retriever. At the three-month follow-up, there was no statistically significant difference in functional outcome between different types of M2 occlusions (p = 0.662), however in the underpowered analysis because of the small sample size of patients, with good clinical outcome mRS 0-2 in 50% of all treated patients. Symptomatic intracranial hemorrhage was found in 6.1% of patients. Lower age (OR 0.932, 95% CI 0.878-0.988) and lower NIHSS score upon admission (OR 0.893, 95% CI 0.805-0.991) were independent predictors of good clinical outcome.
CONCLUSION: Aspiration thrombectomy appeared to be a safe and effective first-line treatment option for patients with M2 occlusion, being the first-line option for almost three-quarters of patients.

Entities:  

Keywords:  Acute ischemic stroke; M2 occlusions; aspiration thrombectomy; endovascular therapy

Mesh:

Year:  2020        PMID: 32397859      PMCID: PMC7446573          DOI: 10.1177/1591019920925678

Source DB:  PubMed          Journal:  Interv Neuroradiol        ISSN: 1591-0199            Impact factor:   1.610


  20 in total

1.  Efficacy of endovascular thrombectomy in patients with M2 segment middle cerebral artery occlusions: meta-analysis of data from the HERMES Collaboration.

Authors:  Bijoy K Menon; Michael D Hill; Antoni Davalos; Yvo B W E M Roos; Bruce C V Campbell; Diederik W J Dippel; Francis Guillemin; Jeffrey L Saver; Aad van der Lugt; Andrew M Demchuk; Keith Muir; Scott Brown; Tudor Jovin; Peter Mitchell; Phil White; Serge Bracard; Mayank Goyal
Journal:  J Neurointerv Surg       Date:  2019-04-11       Impact factor: 5.836

Review 2.  2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.

Authors:  William J Powers; Alejandro A Rabinstein; Teri Ackerson; Opeolu M Adeoye; Nicholas C Bambakidis; Kyra Becker; José Biller; Michael Brown; Bart M Demaerschalk; Brian Hoh; Edward C Jauch; Chelsea S Kidwell; Thabele M Leslie-Mazwi; Bruce Ovbiagele; Phillip A Scott; Kevin N Sheth; Andrew M Southerland; Deborah V Summers; David L Tirschwell
Journal:  Stroke       Date:  2018-01-24       Impact factor: 7.914

3.  Mechanical thrombectomy for acute ischemic stroke with occlusion of the M2 segment of the middle cerebral artery: a meta-analysis.

Authors:  Hamidreza Saber; Sandra Narayanan; Mohan Palla; Jeffrey L Saver; Raul G Nogueira; Albert J Yoo; Sunil A Sheth
Journal:  J Neurointerv Surg       Date:  2017-11-10       Impact factor: 5.836

4.  Contact Aspiration Versus Stent Retriever in Patients With Acute Ischemic Stroke With M2 Occlusion in the ASTER Randomized Trial (Contact Aspiration Versus Stent Retriever for Successful Revascularization).

Authors:  Benjamin Gory; Bertrand Lapergue; Raphael Blanc; Julien Labreuche; Malek Ben Machaa; Alain Duhamel; Gautier Marnat; Suzana Saleme; Vincent Costalat; Serge Bracard; Hubert Desal; Mikael Mazighi; Arturo Consoli; Michel Piotin
Journal:  Stroke       Date:  2017-12-28       Impact factor: 7.914

5.  Endovascular Therapy of M2 Occlusion in IMS III: Role of M2 Segment Definition and Location on Clinical and Revascularization Outcomes.

Authors:  T A Tomsick; J Carrozzella; L Foster; M D Hill; R von Kummer; M Goyal; A M Demchuk; P Khatri; Y Palesch; J P Broderick; S D Yeatts; D S Liebeskind
Journal:  AJNR Am J Neuroradiol       Date:  2016-10-20       Impact factor: 3.825

6.  Thrombectomy for M2 occlusions and the role of the dominant branch.

Authors:  Luís Henrique de Castro Afonso; Guilherme Borghini Pazuello; Guilherme Seizem Nakiri; Lucas Moretti Monsignore; Francisco Antunes Dias; Octávio Marques Pontes-Neto; Daniel Giansante Abud
Journal:  Interv Neuroradiol       Date:  2019-05-14       Impact factor: 1.610

7.  Arterial occlusion revealed by CT angiography predicts NIH stroke score and acute outcomes after IV tPA treatment.

Authors:  John R Sims; Guy Rordorf; Eric E Smith; Walter J Koroshetz; Michael H Lev; Ferdinando Buonanno; Lee H Schwamm
Journal:  AJNR Am J Neuroradiol       Date:  2005-02       Impact factor: 3.825

8.  Effect of Endovascular Contact Aspiration vs Stent Retriever on Revascularization in Patients With Acute Ischemic Stroke and Large Vessel Occlusion: The ASTER Randomized Clinical Trial.

Authors:  Bertrand Lapergue; Raphael Blanc; Benjamin Gory; Julien Labreuche; Alain Duhamel; Gautier Marnat; Suzana Saleme; Vincent Costalat; Serge Bracard; Hubert Desal; Mikael Mazighi; Arturo Consoli; Michel Piotin
Journal:  JAMA       Date:  2017-08-01       Impact factor: 56.272

9.  Endovascular Treatment: The Role of Dominant Caliber M2 Segment Occlusion in Ischemic Stroke.

Authors:  Kars C J Compagne; Pieter M van der Sluijs; Ido R van den Wijngaard; Bob Roozenbeek; Maxim J H L Mulder; Wim H van Zwam; Bart J Emmer; Charles B L M Majoie; Albert J Yoo; Geert J Lycklama À Nijeholt; Hester F Lingsma; Diederik W J Dippel; Aad van der Lugt; Adriaan C G M van Es
Journal:  Stroke       Date:  2019-01-21       Impact factor: 7.914

10.  Endovascular Therapy for Acute Ischemic Stroke With Occlusion of the Middle Cerebral Artery M2 Segment.

Authors:  Amrou Sarraj; Navdeep Sangha; Muhammad Shazam Hussain; Dolora Wisco; Nirav Vora; Lucas Elijovich; Nitin Goyal; Michael Abraham; Manoj Mittal; Lei Feng; Abel Wu; Vallabh Janardhan; Suman Nalluri; Albert J Yoo; Megan George; Randall Edgell; Rutvij J Shah; Clark Sitton; Emilio Supsupin; Suhas Bajgur; M Carter Denny; Peng R Chen; Mark Dannenbaum; Sheryl Martin-Schild; Sean I Savitz; Rishi Gupta
Journal:  JAMA Neurol       Date:  2016-11-01       Impact factor: 18.302

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