Distance to thrombus, ischemic lesion volume and clinical outcome after thrombectomy for M1 middle cerebral artery occlusion
Sprache des Titels:
Englisch
Original Kurzfassung:
Background Stroke resulting from occlusion of the
middle cerebral artery (MCA) can have devastating
consequences, potentially leading to a loss of independence. This study aimed to investigate the relationship between the distance to the thrombus (DT)
and both ischemic lesion volume (ILV) and clinical
outcomes.
Methods We retrospectively evaluated patients with
thromboembolic MCA M1 segment occlusion who underwent neurovascular imaging followed by endovascular thrombectomy (EVT) at two comprehensive
stroke centers over a 3-year period (2018?2020). Preinterventional computed tomography (CT) or magnetic
resonance (MR) angiography was used to measure
DT, defined as the distance from the carotid-T bifurcation to the proximal surface of the M1 occlusion.
Postinterventional CT or MR imaging was employed
to determine the ILV and clinical outcomes were assessed using the modified Rankin scale (mRS) at 3
months.
Results There were 346 patients evaluated. The
median DT was 9.4mm (interquartile range, IQR
6.0?13.7mm) and the median ILV was 13.9ml (IQR
2.2?53.1ml). After adjustment, an increase in DT
was associated with a decrease in odds for a larger
ILV (odds ratio, OR 0.96, 95% confidence interval,
CI 0.92?0.99, p= 0.041). Through this association,
more distal thrombi were associated with good clinical outcome (mRS 0?2; clinical outcome available in
282 patients, p= 0.018). The ILV was inversely associated with better clinical outcome OR 0.52 (95% CI
0.40?0.67).
Conclusion Based on the findings, DT was identified
as an independent albeit weak predictor for ILV and
clinical outcomes in patients with MCA M1 occlusion
who underwent EVT.
Forschungs-