Thrombus migration in emergent M1 middle cerebral artery occlusion.
Clin Neurol Neurosurg
; 237: 108132, 2024 02.
Article
em En
| MEDLINE
| ID: mdl-38310761
ABSTRACT
BACKGROUND AND PURPOSE:
Thrombus migration (TM) is a well-established phenomenon in patients with intracranial vessel occlusion, particularly in those who receive alteplase. However, the relationship between TM, reperfusion success, and clinic-radiological outcomes is still being determined. This study aimed to describe the various outcomes in the event of TM in patients with M1 middle cerebral artery (M1 MCA) occlusion. MATERIALS ANDMETHODS:
The study involved a retrospective analysis of patients undergoing endovascular thrombectomy (EVT) due to M1 MCA occlusion from two tertiary centers between January 2015 and December 2020. The proximal positions of thrombi were measured using a curve tool on CT or MR angiography before EVT. Subsequently, measurements were taken on angiographic imaging. Patients were grouped based on the amount of difference between the two measurements growth (≤ - 10 mm), stability (> -10 mm and ≤ 10 mm), migration (> 10 mm), and resolution.RESULTS:
A total of 463 patients (266 [57%] females, median 76 [interquartile range IQR 65-83] years) were analyzed. Of them, 106 (22.8%) expressed any degree of TM. In multivariate ordinal regression analysis, the alteplase was significantly associated with TM (t = 2.192, p = 0.028), as was the greater interval from first imaging to angiography (t = 2.574, p = 0.010). In multivariate logistical regression analysis, the good clinical outcome measured by the modified Rankin scale (0-2) was not associated with TM status.CONCLUSIONS:
Thrombus migration within the M1 MCA segment occurs in almost a quarter of patients, is associated with alteplase administration, and is mainly irrelevant to radiological and clinical outcome.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Trombose
/
Doenças Vasculares
Limite:
Female
/
Humans
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Male
Idioma:
En
Revista:
Clin Neurol Neurosurg
/
Clin. neurol. neurosurg
/
Clinical neurology and neurosurgery
Ano de publicação:
2024
Tipo de documento:
Article