Thrombectomy for M2 occlusions and the role of the dominant branch

被引：19

作者：

de Castro Afonso, Luis Henrique ^{[1
]}

Pazuello, Guilherme Borghini ^{[1
]}

Nakiri, Guilherme Seizem ^{[1
]}

Monsignore, Lucas Moretti ^{[1
]}

Dias, Francisco Antunes ^{[2
]}

Pontes-Neto, Octavio Marques ^{[2
]}

Abud, Daniel Giansante ^{[1
]}

机构：

[1] Univ Sao Paulo, Med Sch Ribeirao Preto, Div Intervent Neuroradiol, Ave Bandeirantes 3900, BR-14048090 Ribeirao Preto, SP, Brazil

[2] Univ Sao Paulo, Med Sch Ribeirao Preto, Dept Neurol, Ribeirao Preto, SP, Brazil

来源：

INTERVENTIONAL NEURORADIOLOGY | 2019年 / 25卷 / 06期

关键词：

Acute stroke; M2; occlusion; thrombectomy; ACUTE ISCHEMIC-STROKE; MIDDLE CEREBRAL-ARTERY; INDIVIDUAL PATIENT DATA; MECHANICAL THROMBECTOMY; ENDOVASCULAR THERAPY; RANDOMIZED-TRIAL; STENT-RETRIEVER; METAANALYSIS;

D O I：

10.1177/1591019919847693

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

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.

引用

页码：697 / 704

页数：8

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