Styczen, Hanna ORCID: 0000-0002-9623-4156, Maus, Volker, Hesse, Amelie C., Goertz, Lukas, Fischer, Sebastian, Riedel, Christian, Forsting, Michael, Radbruch, Alexander and Behme, Daniel (2020). Impact of early division of the middle cerebral artery on outcome following mechanical thrombectomy. Interv. Neuroradiol., 26 (4). S. 389 - 396. THOUSAND OAKS: SAGE PUBLICATIONS INC. ISSN 2385-2011

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Abstract

Background Mechanical thrombectomy has become the standard care for acute ischemic stroke caused by large vessel occlusion. However, complete reperfusion cannot be achieved in all cases, and several factors influencing the results of mechanical thrombectomy have been investigated. Among others, a tortuous anatomy is associated with lower rates of complete reperfusion. We aimed to investigate whether an early division of the middle cerebral artery has an impact on reperfusion results in mechanical thrombectomy. Methods Retrospective review of consecutive patients with M1 occlusion treated endovascularly between January 2016 and December 2019 at three tertiary care centers. The study group was dichotomized based on the length of the M1 segment. Early division of the middle cerebral artery was defined as a maximum length of 10 mm of the M1 segment. Primary endpoints were first-pass mTICI scores of 3, >= 2c, and >= 2b. Secondary endpoints contained final reperfusion, number of device-passes, time interval from groin puncture to reperfusion, rate of postinterventional symptomatic intracranial hemorrhage, and frequency of emboli of new territory. Results Among 284 included patients, 70 presented with an early division of the M1 segment (25%). Reperfusion results did not differ significantly between early and late division of M1. A higher rate of symptomatic intracranial hemorrhage was found in the group with an early M1 division treated with aspiration only (14.3% vs. 0%; p = 0.013). Patients with late M1 division had a significantly higher rate of large artery sclerosis (19.2% vs. 8.6%, p = 0.039). Conclusion The anatomic variant of an early division of the middle cerebral artery was not a predictor for incomplete reperfusion.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Styczen, HannaUNSPECIFIEDorcid.org/0000-0002-9623-4156UNSPECIFIED
Maus, VolkerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hesse, Amelie C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Goertz, LukasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fischer, SebastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Riedel, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Forsting, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Radbruch, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Behme, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-336362
DOI: 10.1177/1591019920920987
Journal or Publication Title: Interv. Neuroradiol.
Volume: 26
Number: 4
Page Range: S. 389 - 396
Date: 2020
Publisher: SAGE PUBLICATIONS INC
Place of Publication: THOUSAND OAKS
ISSN: 2385-2011
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ISCHEMIC-STROKE; RECANALIZATION; THROMBOLYSIS; ANATOMYMultiple languages
Clinical Neurology; Radiology, Nuclear Medicine & Medical ImagingMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/33636

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