Aims and objectives
Endovascular mechanical embolectomy is the approved standard of treatment for the major vessel occlusion in the acute ischemic stroke.
The aim of this work is to compare the ability of stent retrivers vs thromboaspiration in the clot removal ability for M2 distal segment of mean cerebral artery occlusion.
Methods and materials
Between April 2009 and March 2018,
of 162 patients (mean age 62.7 years) treated for stroke in a single centre,
satisfying the classic inclusion criteria of the EST,
using stent-retrivers or aspiration,
we enucleated 29,62% (48/162) M2-M3 occlusion cases.
We used for basal CT imaging,
CT Angiography and Perfusion CT,
on Brilliance 64 layers and Angiography (AGF) system on Allura Xper system or Toshiba Infinix VF-i Biplane for the determination of presence,
site and extension of occlusion and the pial collaterals.
The primary outcomes were:...
The average NIHSS at presentation and DGP was 24 (range 9-33) and 128 (93-157min).
Of the 48 cases of distal arterial occlusion of mean,
31/48 (64.58%) concerned the stretch M2 and in particular 18 (58.6%) cases on the primary trunk,
6/48 (19.35%) on insular branches,
7/48 (22.58%) on the inferior-lateral trunk whereas in 17/48 (35.41%) cases,
isolated distal M3 distal tract was shown to be isolated.
Statistically significant differences were observed between the group treated with stent-retrivers 21/48 (43.75%) and the one treated with 27/48...
The composition of the clot and anatomical factors could explain the observed difference in terms of outcomes.
A combined multimodal approach also for endovascular treatment of distal media stroke could lead to very high recanalization rates.
Interventional and Vascular Radiology
et al; EPITHET Investigators.
Effects of alteplase beyond 3 h after stroke
in the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET): a placebo-controlled randomised trial.
et al; DEFUSE Investigators.
Magnetic resonance imaging profiles predict
clinical response to early reperfusion: the diffusion and perfusion imaging evaluation for understanding stroke evolution (DEFUSE) study.
Ann Neurol. 2006;60:508–517.