Universität zu Köln

Dorn, Franziska ORCID: 0000-0001-9093-8307, Lockau, Hannah, Stetefeld, Henning, Kabbasch, Christoph, Kraus, Bastian, Dohmen, Christian, Henning, Tobias, Mpotsaris, Anastasios ORCID: 0000-0002-1275-8164 and Liebig, Thomas (2015). Mechanical Thrombectomy of M2-Occlusion. J. Stroke Cerebrovasc. Dis., 24 (7). S. 1465 - 1471. AMSTERDAM: ELSEVIER SCIENCE BV. ISSN 1532-8511

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Abstract

Background: There is growing evidence for the efficacy of mechanical thrombectomy in acute stroke patients with large-vessel occlusions in the anterior circulation. Although distal occlusions of the middle cerebral artery (MCA) can cause severe clinical symptoms, endovascular therapy is not considered here as the first choice. The aim of our study was to prove the efficacy and safety of mechanical thrombectomy for distal occlusion types in the anterior circulation (M2-segment). Methods: Stentretriever-based thrombectomy was performed in 119 patients with acute MCA occlusions between October 2011 and April 2013: 104 (87.4%) were M1- and 15 (12.6%) M2-occlusions. These groups were compared with regard to recanalization success, periprocedural complications, hemorrhage, and modified Rankin Scale (mRS) at 90 days. Results: Thrombolysis in cerebral infarction 2b/3 reperfusion was more frequent in M2- than in M1-occlusions (93.3% versus 76.0%; P = .186). There was no significant difference in the mean National Institutes of Health Stroke Scale between the M1- and the M2-group both at admission and at discharge (16.18 +/- 7.30 versus 13.73 +/- 8.30, P = .235; 9.36 +/- 8.60 versus 7.43 +/- 9.84, P = .446). A good clinical outcome (mRS 0-2) at 3 months was more frequent in the M2-group (60% versus 43.3%; P = .273) and mortality was higher in the M1-group (21.2% versus 6.7%; P = .297). There were 3 periprocedural complications in the M1- and none in the M2-group. Conclusions: Endovascular treatment of M2-occlusions in severely affected patients is not associated with a higher procedural risk or postprocedural hemorrhage. Compared with M1-occlusions, there was a greater chance for a good angiographic and clinical result in our case series. Therefore, stentretriever-based thrombectomy should also be considered for patients with severe symptoms because of an acute M2-occlusion. (C) 2015 by National Stroke Association

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Dorn, Franziska UNSPECIFIED orcid.org/0000-0001-9093-8307 UNSPECIFIED Lockau, Hannah UNSPECIFIED UNSPECIFIED UNSPECIFIED Stetefeld, Henning UNSPECIFIED UNSPECIFIED UNSPECIFIED Kabbasch, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Kraus, Bastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Dohmen, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Henning, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Mpotsaris, Anastasios UNSPECIFIED orcid.org/0000-0002-1275-8164 UNSPECIFIED Liebig, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-400430
DOI:	10.1016/j.jstrokecerebrovasdis.2015.04.013
Journal or Publication Title:	J. Stroke Cerebrovasc. Dis.
Volume:	24
Number:	7
Page Range:	S. 1465 - 1471
Date:	2015
Publisher:	ELSEVIER SCIENCE BV
Place of Publication:	AMSTERDAM
ISSN:	1532-8511
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE ISCHEMIC-STROKE; MIDDLE CEREBRAL-ARTERY; TISSUE-PLASMINOGEN-ACTIVATOR; RANDOMIZED CONTROLLED-TRIAL; ENDOVASCULAR TREATMENT; INTERVENTIONAL MANAGEMENT; INTRAVENOUS THROMBOLYSIS; RECANALIZATION; OCCLUSIONS; REVASCULARIZATION Multiple languages Neurosciences; Peripheral Vascular Disease Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/40043