Mechanical thrombectomy of M1 and M2 middle cerebral artery occlusions.
J Neurointerv Surg
; 10(4): 330-334, 2018 Apr.
Article
en En
| MEDLINE
| ID: mdl-28705890
ABSTRACT
BACKGROUND:
Over half of patients who receive intravenous tissue plasminogen activator for middle cerebral artery division (MCA-M2) occlusion do not recanalize, leaving a large percentage of patients who may need mechanical thrombectomy (MT). However, the outcomes of MT for M2 occlusion have not been well characterized.OBJECTIVE:
To determine if MT of M2 occlusion is as safe and efficacious as current standard-of-care MT for M1 occlusions.METHODS:
With institutional review board approval, we retrospectively reviewed records of 212 patients undergoing MT for isolated MCA M1 or M2 occlusions during a 36-month period (Sept 2013 to Sept 2016) at two centres. Treatment variables, clinical outcomes, and complications in each group were recorded.RESULTS:
There were 153 M1 MCA occlusions and 59 M2 MCA occlusions. No statistically significant difference was found in the rate of mortality (20% in M1 vs 13.6% in M2, p=0.32), excellent (34.5% vs 37.3%, p=0.75) or good (51% vs 55.9%, p=0.54) clinical outcomes between the two groups. Infarct volumes (48.4 mL vs 46.2 mL, p=0.62) were comparable between the two groups, as were the rates of hemorrhagic (3.3% vs 3.4%, p=1.0) and procedural complications (3.3% vs 5.1%, p=0.69).CONCLUSION:
Our data on MT targeting M2 occlusions demonstrates reasonable safety and functional outcomes. Further randomized clinical trials are needed to clarify which patients may benefit from MT for M2 occlusions.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Trombectomía
/
Arteria Cerebral Media
/
Infarto de la Arteria Cerebral Media
Tipo de estudio:
Observational_studies
Límite:
Aged
/
Aged80
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Neurointerv Surg
Año:
2018
Tipo del documento:
Article
País de afiliación:
Estados Unidos