Endovascular treatment for proximal middle cerebral artery occlusion due to underlying intracranial atherosclerotic disease: A retrospective single-center case series

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery Pub Date : 2024-09-20 DOI:10.1016/j.clineuro.2024.108558

Jonghoon Kim, Chul-Hoon Chang

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Abstract

Objective

To compare treatment outcomes between patients who received a front-line stent-retriever thrombectomy (SRT) or first stenting without retrieval (FRESH) for treating proximal M1 occlusion due to underlying intracranial atherosclerotic disease (ICAD).

Methods

We retrospectively reviewed consecutive acute ischemic stroke (AIS) patients with intracranial large vessel occlusion (LVO) in the anterior circulation who underwent endovascular treatment (EVT) between January 2017 and August 2021 at Yeungnam University Medical Center. LVO in the anterior circulation was classified according to etiology as follows: Embolic group and ICAD group. Occlusion of the proximal M1 due to ICAD were enrolled in this study. The ICAD group was divided into SRT and FRESH groups according to the treatment method.

Results

Among the 72 patients in the ICAD group, 55 patients had occlusion of the M1, and 27 had occlusion of the proximal M1 (27/55, 49.1 %). Among the 27 patients, 11 (40.7 %) underwent SRT and 16 (59.3 %) underwent FRESH. The puncture-to-recanalization time was significantly shorter in the FRESH group (28 min vs. 52 min, p = 0.023). Symptomatic ICH tended to occur more frequently in the SRT group than in the FRESH group (27.3 % vs. 0.0 %, p=0.056). There was a nonsignificant trend towards a good functional outcome in the FRESH group compared to the SRT group (81.3 % vs. 45.5 %, p=0.097).

Conclusion

In the FRESH group, the puncture-to-recanalization time was significantly shorter, symptomatic ICH tended to occur less frequently, and good functional outcomes were more common.

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颅内动脉粥样硬化性疾病导致大脑中动脉近端闭塞的血管内治疗：回顾性单中心病例系列

目的比较在治疗颅内动脉粥样硬化性疾病（ICAD）导致的 M1 近端闭塞时，接受前线支架-取栓术（SRT）或首次支架植入术（FRESH）的患者的治疗效果。方法我们回顾性研究了2017年1月至2021年8月期间在岭南大学医疗中心接受血管内治疗（EVT）的前循环颅内大血管闭塞（LVO）的连续急性缺血性卒中（AIS）患者。前循环 LVO 根据病因分类如下：栓塞组和 ICAD 组：栓塞组和 ICAD 组。ICAD导致的M1近端闭塞被纳入本研究。结果 ICAD 组的 72 例患者中，55 例为 M1 闭塞，27 例为 M1 近端闭塞（27/55，49.1%）。在这 27 名患者中，11 人（40.7%）接受了 SRT 治疗，16 人（59.3%）接受了 FRESH 治疗。FRESH 组从穿刺到复位的时间明显更短（28 分钟对 52 分钟，P = 0.023）。与 FRESH 组相比，SRT 组发生症状性 ICH 的频率更高（27.3% 对 0.0%，P=0.056）。与 SRT 组相比，FRESH 组出现良好功能预后的趋势并不明显（81.3% 对 45.5%，P=0.097）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neurology and Neurosurgery 医学-临床神经学

CiteScore

3.70

自引率

5.30%

发文量

358

审稿时长

46 days

期刊介绍： Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.