Outcomes and differences by occluded vessel after endovascular thrombectomy for isolated medium vessel occlusions

Hidetoshi Matsukawa; Kazutaka Uchida; Conor Cunningham; Mohammad-Mahdi Sowlat; Sameh Samir Elawady; Ilko Maier; Pascal Jabbour; Joon-Tae Kim; Stacey Quintero Wolfe; Ansaar Rai; Robert M. Starke; Marios-Nikos Psychogios; Amir Shaban; Adam Arthur; Hugo Cuellar; Brian M. Howard; Ali Alawieh; Daniele G. Romano; Omar Tanweer; Justin Mascitelli; Isabel Fragata; Adam Polifka; Joshua Osbun; Roberto Crosa; Charles Matouk; Min S. Park; Waleed Brinjikji; Mark Moss; Richard Williamson; Pedro Navia; Peter Kan; Reade De Leacy; Shakeel Chowdhry; Mohamad Ezzeldin; Alejandro M. Spiotta; Michael R. Levitt; Shinichi Yoshimura; Stroke Thrombectomy and Aneurysm Registry (STAR) Collaborators

doi:10.1016/j.jns.2024.123054

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Outcomes and differences by occluded vessel after endovascular thrombectomy for isolated medium vessel occlusions

Journal article

Peer reviewed

Outcomes and differences by occluded vessel after endovascular thrombectomy for isolated medium vessel occlusions

Hidetoshi Matsukawa, Kazutaka Uchida, Conor Cunningham, Mohammad-Mahdi Sowlat, Sameh Samir Elawady, Ilko Maier, Pascal Jabbour, Joon-Tae Kim, Stacey Quintero Wolfe, Ansaar Rai, …

Journal of the neurological sciences, Vol.462, 123054

07/15/2024

DOI: 10.1016/j.jns.2024.123054

PMID: 38889600

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https://resolver.sub.uni-goettingen.de/purl?gro-2/144110View

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Abstract

The outcomes of endovascular thrombectomy (EVT) for medium vessel occlusions (MeVOs) of specific vascular territories remain unknown. We aimed to investigate EVT outcomes by MeVO locations using the data from an ongoing international multicenter registry. Patients with isolated MeVO who underwent EVT between January 2013 and December 2022 were retrospectively analyzed. Isolated MeVO was defined as an occlusion of the A2 or A3 (A2/A3), M2 or M3, and P2 or P3 (P2/P3). Outcomes included a 90-day modified Rankin score (mRS) of 0–2, successful recanalization (modified Thrombolysis in Cerebral Infarction score ≥ 2b), early neurological deterioration (END) or improvement (ENI), and 90-day mortality. END was defined as a worsening of ≥4 points from the baseline National Institutes of Health Stroke Scale (NIHSS) score within 24 h of EVT, while ENI was defined as an improvement of ≥4 points from the baseline NIHSS score within 24 h of EVT. 1744 MeVOs included. Compared to M2 occlusions (n = 1542, 88.4%), A2/A3 (n = 36, 2.1%) occlusions had lower odds of 90-day mRS 0–2 (adjusted odds ratio [aOR] 0.30, 95% confidence interval [CI] 0.11–0.80), and P2/P3 occlusions (n = 49, 2.8%) had lower odds of successful recanalization (aOR 0.19, 95% CI 0.07–0.50), and higher odds of END (aOR 3.53, 95% CI 1.35–9.25). Other outcomes showed no significant differences. A2/A3 occlusions were more likely to have worse outcomes compared to M2 occlusions after EVT for patients with isolated MeVOs. •Endovascular thrombectomy outcomes may differ by medium vessel occlusion territories.•A2 or A3 occlusions had lower odds of 90-day modified Rankin Scale score of 0–2.•P2 or P3 occlusions had lower odds of successful recanalization.•P2 or P3 occlusions had higher odds of early neurological deterioration.•Efforts should be aimed at improving outcomes following A2 or A3 occlusions.

Acute ischemic stroke

Anterior cerebral artery

Endovascular thrombectomy

Medium vessel occlusion

Outcomes

Details

Title: Subtitle: Outcomes and differences by occluded vessel after endovascular thrombectomy for isolated medium vessel occlusions
Creators: Hidetoshi Matsukawa - Medical University of South Carolina
Kazutaka Uchida - Hyogo University
Conor Cunningham - Medical University of South Carolina
Mohammad-Mahdi Sowlat - Medical University of South Carolina
Sameh Samir Elawady - Medical University of South Carolina
Ilko Maier - Universitätsmedizin Göttingen
Pascal Jabbour - Thomas Jefferson University
Joon-Tae Kim - Chonnam National University Hospital
Stacey Quintero Wolfe - Wake Forest University
Ansaar Rai - West Virginia University
Robert M. Starke - University of Miami Health System
Marios-Nikos Psychogios - University of Basel
Amir Shaban - University of Iowa
Adam Arthur - Semmes Murphey Foundation
Hugo Cuellar - Louisiana State University
Brian M. Howard - Emory University
Ali Alawieh - Emory University
Daniele G. Romano - Ospedali Riuniti San Giovanni di Dio e Ruggi d'Aragona
Omar Tanweer - Baylor College of Medicine
Justin Mascitelli - The University of Texas Health Science Center at Houston
Isabel Fragata - Unidade Local de Saúde de São José
Adam Polifka - University of Florida
Joshua Osbun - Washington University in St. Louis
Roberto Crosa - Department of Neurosurgery, Endovascular Neurological Center, Montevideo, Uruguay
Charles Matouk - Yale University
Min S. Park - University of Virginia
Waleed Brinjikji - Mayo Clinic
Mark Moss - Washington Regional Medical Center
Richard Williamson - Allegheny Health Network
Pedro Navia - Hospital Universitario La Paz
Peter Kan - The University of Texas Medical Branch at Galveston
Reade De Leacy - Mount Sinai Health System
Shakeel Chowdhry - NorthShore University HealthSystem
Mohamad Ezzeldin - University of Houston System at Cinco Ranch
Alejandro M. Spiotta - Medical University of South Carolina
Michael R. Levitt - University of Washington
Shinichi Yoshimura - Hyogo Medical University
Stroke Thrombectomy and Aneurysm Registry (STAR) Collaborators
Resource Type: Journal article
Publication Details: Journal of the neurological sciences, Vol.462, 123054
DOI: 10.1016/j.jns.2024.123054
PMID: 38889600
NLM abbreviation: J Neurol Sci
ISSN: 0022-510X
eISSN: 1878-5883
Publisher: Elsevier B.V
Language: English
Date published: 07/15/2024
Academic Unit: Neurology
Record Identifier: 9984649046002771

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