Interventional Neuroradiology最新文献

{"title":"Embolization of the middle meningeal artery for chronic subdural hematoma: The OTEMACS multicenter, randomized, clinical trial protocol.","authors":"Sam Ng, Imad Derraz, Gaultier Marnat, Vincent Jecko, Jean Papaxanthos, Guillaume Bellanger, Christophe Cognard, Jean-Christophe Sol, Tuan Le Van, Moncef Berhouma, Pierre Thouant, Timothée Jacquesson, Omer Eker, Hassan El Fertit, David S Liebskind, Nicolas Molinari, Nicolas Lonjon, Vincent Costalat","doi":"10.1177/15910199251356098","DOIUrl":"10.1177/15910199251356098","url":null,"abstract":"<p><p>BackgroundThe role of middle meningeal artery (MMA) embolization as an adjunct to standard treatment in chronic subdural hematoma (CSDH) is debated. Further randomized trials are needed to establish MMA embolization as an essential therapeutic option for CSDH. The OTEMACS study aims to assess the adjunctive benefit of MMA embolization in patients undergoing either conservative or surgical treatment for CSDH.MethodsOTEMACS is a multicenter, prospective, randomized controlled clinical trial with an open-label and blinded endpoint evaluation (PROBE) design. Patients with symptomatic CSDH treated either with conservative or surgical treatment are randomized 1:1 to receive MMA embolization within 72 h (experimental arm) or standard of care alone (control arm). The primary efficacy outcome is a composite of clinical and radiological events, including surgical rescue or revision surgery within 90 ± 14 days postrandomization or radiological remaining of the CSDH thickness >10 mm at 90 ± 14 days postrandomization. The primary safety outcome included all-cause mortality. Secondary outcomes included the modified Rankin scale, Barthel index, EuroQol-5, and Mini Mental State Examination. The number of patients to be included is 440.ResultsThe trial debuted in October 2021 in six centers, in France. A preplanned interim analysis was performed after the enrollment and completion of the follow-up of 220 patients, and the Data Safety Monitoring Board decided to stop the trial for efficacy. The final results will be made available upon completion of the enrollment.ConclusionsOTEMACS will provide additional evidence for the clinical and radiological efficacy and safety of MMA embolization in patients with CSDH.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251356098"},"PeriodicalIF":1.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The rarely described association between pseudoaneurysm and aberrant ICA: A case series.","authors":"Paul Yousif, Paul Farnsworth, Matthew Carlson, Kirk Welker, Julie Guerin, Girish Bathla, Ahmed O El Sadaney, Jack Lane","doi":"10.1177/15910199251353316","DOIUrl":"10.1177/15910199251353316","url":null,"abstract":"<p><p>Aberrant internal carotid artery (ICA) is a vascular anomaly in which a segment of the ICA courses through the middle ear. The association of aberrant ICAs and pseudoaneurysm formation is not well known and can be an important finding to recognize on imaging. In this series, we present three cases of aberrant ICAs having asymmetric contour deformities consistent with pseudoaneurysms diagnosed utilizing CT of the temporal bone.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251353316"},"PeriodicalIF":1.7,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12234509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is first-pass effect a meaningful metric to evaluate thrombectomy technologies?","authors":"Arjun Agrawal, Akash S Agrawal, Jase L Howell, Sevin B Barringer-Hoonhout, James D Fleck, Jason S Mackey, Andrew J DeNardo, Daniel P Gibson, Krishna Amuluru, Yasir Saleem, Charles G Kulwin, Troy D Payner, Kushal J Shah, J Mocco, Daniel H Sahlein","doi":"10.1177/15910199251351167","DOIUrl":"10.1177/15910199251351167","url":null,"abstract":"<p><p>BackgroundGood clinical outcomes following stroke thrombectomy have been associated with successful reperfusion following a single pass, often referred to as the first pass effect (FPE). Inherent in FPE is a potential association with rapid recanalization. It remains unclear if the benefit associated with FPE is an epiphenomenon rather than a meaningful metric to evaluate thrombectomy. We retrospectively analyzed a high-volume single-practice database to evaluate the association of FPE with good clinical outcome.MethodsA database of 1047 consecutive thrombectomies from 2011 to 2020 was retrospectively queried. Demographics and presentation/procedural metrics were correlated with clinical outcome (3-month modified Rankin Scale (mRS)); patients aged 18 years and older with 3-month clinical follow-ups were included. Univariate analysis was performed to evaluate for an association with good clinical outcome (mRS 0-2) at 90 days. Variables meeting a univariate analysis <i>P</i>-value of 0.05 were included in multivariate analyses. Variables included time of onset to recanalization (OTR), onset to puncture (OTP), and puncture to recanalization (PTR), as well as the number of passes.ResultsA total of 685 patients met the criteria for inclusion. Univariate analysis identified nine variables associated with good clinical outcome at 90 days. Multivariate analysis found OTP, patient age, and successful reperfusion (mTICI ≥ 2B) were associated with good clinical outcome. We built a multivariate model across a range of ratios of PTR to OTR. PTR became significantly associated with good clinical outcome (<i>P</i> = 0.044) when PTR/OTR ≥ 3%. Further subset analyses were performed using a conventional definition of FPE. All multivariate analyses revealed time metrics were significantly associated with good clinical outcome while one versus multiple passes was not.ConclusionsThis study demonstrates that time, age, and degree of recanalization are highly associated with good clinical outcome following thrombectomy, whereas the number of passes is not.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251351167"},"PeriodicalIF":1.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Illustrated step-by-step guide to stent-assisted coiling of wide-neck posterior inferior cerebellar aneurysm via a contralateral vertebral artery approach.","authors":"Julio Isidor, Mohammad-Mahdi Sowlat, Rahim Abo Kasem, Ahmed Muthana, Zachary S Hubbard, Conor M Cunningham, Hasna Loulida, Jonathan Lena, Alejandro M Spiotta","doi":"10.1177/15910199251345635","DOIUrl":"10.1177/15910199251345635","url":null,"abstract":"<p><p>Background and ObjectivesPosterior inferior cerebellar artery (PICA) aneurysms are uncommon, occurring in 0.5% to 3% of all intracranial aneurysms. Due to the distinct anatomy and varying geometrical configuration at the PICA origin, endovascular treatment can be challenging. The contralateral vertebral artery approach to these aneurysms may provide a more advantageous route for endovascular treatment. We describe a series of eight cases of contralateral vertebral artery (VA) approach for stent-assisted coiling of PICA aneurysms.MethodsWe performed a retrospective review of all patients from 2013 in our center who were diagnosed with PICA aneurysm and treated with stent-assisted coiling using a contralateral VA approach. Our study was conducted under the Institutional Review Board (IRB) at our institution, and informed consent was obtained from all patients prior to the procedures. Patient characteristics, angiographic studies, and clinical course were reviewed<b>.</b>ResultsEight patients were included with a median age of 53 [IQR; 48-62]. Five patients (62.5%) had another aneurysm in addition to PICA. Three (37.5%) aneurysms had previously undergone primary coil embolization. The remaining five patients (62.5%) were index treatments. Transfemoral approach (TFA) was used in 7 patients and transradial approach (TRA) was used in 1 patient. The immediate Raymond Roy occlusion (RROC) was I (25%), II (50%) and III (25%). Follow-up RROC (range 6-12 months) were improved to class I in the majority (62.5%) and none were III.ConclusionsStent-assisted coiling via contralateral vertebral artery approach is an effective technique for PICA aneurysm treatment with favorable follow up occlusion rate.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251345635"},"PeriodicalIF":1.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing mechanical thrombectomy - The impact of cath lab staff turnover on stroke thrombectomy times.","authors":"Samantha Miller, Alman Rehman, Daniel Almquist, Wondewossen G Tekle, Ameer E Hassan","doi":"10.1177/15910199251347783","DOIUrl":"10.1177/15910199251347783","url":null,"abstract":"<p><p>BackgroundCath lab staff turnover increased dramatically after the COVID pandemic making it difficult to retain neurology-trained cath lab technicians (neuro-CLTs). We investigated the impact this had on local stroke quality metrics.MethodsThis is a retrospective study of a prospectively maintained thrombectomy (EVT) patient database at a single comprehensive stroke center from December 2021 through October 2023. Included patients underwent EVT for treatment of acute ischemic large vessel occlusion (LVO) stroke and had no missing outcomes data. Patients were grouped based on whether a neuro-CLT or non-neurology-trained CLT (other-CLT) was present for the procedure. Outcomes of interest included time from arterial access to the first EVT pass and time from cath lab arrival to arterial access.ResultsWe observed a faster median time from access to first pass when working with neuro-CLTs (10 min IQR 7-15) compared to other-CLTs (15 min IQR 10-24, <i>P</i> = .004). We also observed a faster median time from CL arrival to access with neuro-CLTs (22 min IQR 17-29) compared to other-CLT (27 min IQR 20-34, <i>P</i> = .036). There was a greater likelihood of access to first pass time <10 min with neurology-trained techs (47% versus 25%, <i>P</i> = .009, OR 2.67).ConclusionNeurology-trained CLTs were associated with great efficiency in EVT workflow, saving a median of 10 min from cath lab arrival to first pass. Our data supports the development of organized training programs and competency standards for neuro-CLTs. Future prospective multi-center studies are necessary to establish external validity and the effect on patient outcomes.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251347783"},"PeriodicalIF":1.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flow diversion for treatment of acutely ruptured intracranial aneurysms: Comparison of complications and clinical outcomes with coil embolization.","authors":"Alis J Dicpinigaitis, Ravnit Singh, Rahim Hirani, Smit P Shah, Noor A Mahmoud, Iman Moeini Naghani, Chirag D Gandhi, Fawaz Al-Mufti","doi":"10.1177/15910199251351163","DOIUrl":"10.1177/15910199251351163","url":null,"abstract":"<p><p>IntroductionAlthough flow diversion (FD) has become a major treatment modality for unruptured intracranial aneurysms, it has been used as an off-label therapy for ruptured aneurysms whose morphologies or other characteristics may not be amenable to traditional coil embolization (CE). Previous literature has demonstrated high angiographic occlusion rates for FD in the acute setting, but also high rates of peri-procedural complications (some of which result from use of dual anti-platelet therapy).MethodsAneurysmal subarachnoid hemorrhage (aSAH) hospitalizations treated with endovascular therapy were identified in the National Inpatient Sample (NIS) in 2020. The primary exposure was treatment with FD (identified using a dedicated ICD-10-CM billing code specifying FD intraluminal device), and the primary endpoints were favorable outcome (defined by the NIS Subarachnoid Hemorrhage Outcome Measure, shown to have high concordance with modified Rankin Scale scores < 2 at 90 days following discharge) and peri-procedural ischemic and hemorrhagic complications (PPIHC). Endpoints were compared between FD and CE following 1:1 propensity score matching, adjusting for age, Hunt and Hess grade, comorbidity burden, and aneurysm location.Results7780 aSAH hospitalizations were identified, 150 (1.9%) of which documented treatment with FD, the remainder with CE. 16.7% of FD procedures were preceded by CE. Median treatment time with FD was admission day 1 (1-8) (IQR). Favorable outcomes were achieved in 46.7% of FD cases (and in 47.6% of CE cases), while PPIHC complications were seen in less than 3.3% of cases (and in 2.1% of CE cases). Following propensity score adjustment, 150 FD cases were matched to 150 CE cases, and rates of favorable outcome (46.7% vs. 50.0%, p = 0.563) and PPIHC (3.3% vs. 6.7%, p = 0.185) did not differ between the two treatment modalities.ConclusionFD demonstrated similar clinical outcomes and complication rates in comparison with CE for the treatment of ruptured aneurysms.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251351163"},"PeriodicalIF":1.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurointerventional procedures using sheathless 8 Fr Optimo balloon guide catheter via transradial access: A single-center experience with 100 cases.","authors":"Taichiro Imahori, Shigeru Miyake, Ichiro Maeda, Hiroki Goto, Rikuo Nishii, Haruka Enami, Daisuke Yamamoto, Hirotoshi Hamaguchi, Kohkichi Hosoda, Naoki Kaneko, Nobuyuki Sakai, Takashi Sasayama","doi":"10.1177/15910199251348744","DOIUrl":"10.1177/15910199251348744","url":null,"abstract":"<p><p>ObjectiveThis study aimed to evaluate the feasibility and safety of neurointerventional procedures performed via transradial access (TRA) using a sheathless 8 Fr Optimo balloon guide catheter (BGC).MethodsWe retrospectively analyzed 100 consecutive neurointerventional procedures performed via TRA using a sheathless 8 Fr Optimo BGC at a single center. Technical success was defined as the successful delivery of the BGC to the target vessel without conversion to an alternative access site or catheter system, along with the completion of the planned procedure.ResultsA total of 100 procedures were performed in 95 patients (median age: 75 years; 63% male). The most common interventions were aneurysm coiling or flow diversion (45%) and carotid artery stenting (36%). Target vessels for BGC placement included the right carotid (59%), left carotid (31%), right vertebral (4%), and left vertebral (6%) arteries. The median BGC navigation time was 12 min (interquartile range: 7-20). Technical success was achieved in 95% of procedures. In five cases, conversion to transulnar, transbrachial, or transfemoral access was required; nevertheless, all planned procedures were completed successfully. Balloon inflation was utilized in 37% of procedures for distal embolic protection, rupture management, or device delivery support. No major access-related complications were observed. Symptomatic non-access-related periprocedural complications occurred in 3% of cases. The overall mortality rate was 2%.ConclusionsNeurointerventional procedures performed via TRA using a sheathless 8 Fr Optimo BGC appear to be feasible and safe, offering a high technical success rate and a low incidence of access-related complications.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251348744"},"PeriodicalIF":1.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early experience with Target Tetra coils for treatment of small and very small ruptured intracranial aneurysms.","authors":"Amol Mehta, Joshua Finesilver, Daryl Goldman, Tomoyoshi Shigematsu, Christopher P Kellner, Shahram Majidi, Reade De Leacy, Johanna Fifi, Michael Travis Caton","doi":"10.1177/15910199251351735","DOIUrl":"10.1177/15910199251351735","url":null,"abstract":"<p><p>BackgroundEndovascular treatment of small (< 5 mm) and very small (≤ 3 mm) ruptured intracranial aneurysms remains technically challenging, historically carrying elevated procedural risks. Advances in coil technology, such as the Target Tetra Detachable Coil (TTDC), aim to improve embolization safety and efficacy. However, limited data exist on outcomes using TTDC coils specifically for ruptured aneurysms.ObjectiveTo evaluate the safety, angiographic efficacy, and clinical outcomes of TTDC for small and very small ruptured intracranial aneurysms.MethodsWe retrospectively analyzed 36 patients with ruptured intracranial aneurysms ≤5 mm treated using TTDC between 2023 and 2025 at a single center. Aneurysms were classified as small (<i>n</i> = 28) or very small (<i>n</i> = 8). Patient demographics, aneurysm characteristics, procedural details, angiographic outcomes, clinical outcomes, and complications were analyzed.ResultsMedian patient age was 57 years (IQR 43-73); 33.3% were male. The mean aneurysm dome height was 2.6 ± 0.9 mm, the mean neck diameter was 2.4 ± 0.7 mm, and the median dome-to-neck ratio was 1.0. Immediate complete occlusion (Raymond-Roy Class I) was achieved in 42.7% of aneurysms, and residual neck filling (Raymond-Roy Class II) in 25.0%. Follow-up imaging (mean 4.9 months) showed complete occlusion in 37.5% of aneurysms. Recanalization occurred in 29.2% of patients with repeat imaging and 6 (25%) requiring retreatment. Favorable clinical outcomes (mRS 0-2) occurred in 75.0%. Procedural complications occurred in 13.9% (five cases), including two intraprocedural perforations. No rebleeding occurred.ConclusionEarly experience with TTDC demonstrates safe, effective embolization for ruptured small and very small intracranial aneurysms, supporting the broader use of modern coils in these challenging lesions.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251351735"},"PeriodicalIF":1.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transradial access of neuro-endovascular interventions with aberrant right subclavian arteries: Case series and literature review.","authors":"Yoji Kuramoto, Shoichiro Tsuji, Takanori Kubo, Koichiro Shindo, Kazutaka Uchida, Manabu Shirakawa, Shinichi Yoshimura","doi":"10.1177/15910199251345110","DOIUrl":"10.1177/15910199251345110","url":null,"abstract":"<p><p>IntroductionTransradial artery access (TRA) reduces puncture site complications and is becoming standard in neuro-endovascular procedures. An aberrant right subclavian artery (ARSA) is a congenital anomaly affecting 0.5% to 2% of the population, complicating cerebral angiography via TRA.Case presentationThree cases of neuro-endovascular treatment involving ARSA and TRA are reported. In the first case, ARSA was detected during the induction of a 7Fr RIST from the right distal radial artery (dRA), and treatment continued with transfemoral access. In the second case, ARSA was identified pre-interventionally, and a left dRA approach was selected with a 6Fr Axcelguide Stiff-J with pulling-up methods. The third case involved the successful induction of a 7Fr RIST with some tips to the right internal carotid artery, followed by the placement of a flow diverter.DiscussionARSA, a congenital anomaly, complicates TRA due to its abnormal bifurcation. Cerebral angiography with ARSA is challenging, often requiring alternative access routes. We gathered our 3 reports and the 11 literature reports, with 3 switching to femoral access due to the difficulty of catheter navigation. Two guiding methods in TRA are discussed, with the \"pull-back technique\" often applied with the Simmonds-type guiding catheter but sometimes ineffective.ConclusionThree neuro-interventional cases with TRA and ARSA are presented, with two successful treatments. The limited cases underscore the need for preoperative access route examination and the development of alternative methods in case of failure. This urgency highlights the importance of ongoing research and innovation in the field.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251345110"},"PeriodicalIF":1.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment outcomes of successful M1 versus M2 thrombectomy for low-ASPECTS stroke patients.","authors":"Huanwen Chen, Marco Colasurdo, Hidetoshi Matsukawa, Conor Cunningham, Ilko Maier, Pascal Jabbour, Joon-Tae Kim, Stacey Quintero Wolfe, Ansaar Rai, Robert M Starke, Marios-Nikos Psychogios, Amir Shaban, Nitin Goyal, Shinichi Yoshimura, Hugo Cuellar, Brian Howard, Ali Alawieh, Ali Alaraj, Mohamad Ezzeldin, Daniele G Romano, Omar Tanweer, Justin Mascitelli, Isabel Fragata, Adam Polifka, Fazeel Siddiqui, Joshua Osbun, Roberto Crosa, Ramesh Grandhi, Charles Matouk, Min S Park, Michael R Levitt, Waleed Brinjikji, Mark Moss, Ergun Daglioglu, Richard Williamson, Pedro Navia, Shakeel Chowdhry, David J Altschul, Alejandro M Spiotta, Peter Kan","doi":"10.1177/15910199251343283","DOIUrl":"10.1177/15910199251343283","url":null,"abstract":"<p><p>BackgroundThe effectiveness of endovascular thrombectomy (EVT) for low Alberta Stroke Program Early CT score (ASPECTS) stroke patients with occlusion of the second segment of the middle cerebral artery (M2) is unclear.MethodsThis was a multicenter retrospective study. Patients with M1 or M2 occlusions and low ASPECTS (<6) who underwent successful EVT (modified treatment in cerebral ischemia score of 2b or higher) were included. Primary outcome was futile EVT reperfusion (defined as 90-day modified Rankin scale of 5 or 6). Other outcomes of interest include acceptable outcomes (modified Rankin scale of 3 or less) and intracranial hemorrhage (ICH), and all-cause 90-day mortality. Outcomes for M1 patients were compared to M2 patients with multivariable logistic regression models accounting for potential confounders.Results173 patients with M1 or M2 occlusions and low ASPECTS (<6) who underwent successful EVT were identified. After multivariable adjustments, M2 patients had significantly higher odds of futile reperfusion (OR 5.48 [95%CI 1.91 to 15.7], p = 0.002), lower odds of acceptable outcomes (OR 0.33 [95%CI 0.12 to 0.89], p = 0.028), and higher odds of all-cause mortality (OR 4.90 [95%CI 1.65 to 14.5], p = 0.004). These findings suggest that EVT's efficacy for low-ASPECTS stroke patients may be diminished for patients with M2 occlusions. M2 occlusion was not significantly associated with ICH.ConclusionsAmong low-ASEPCTS stroke patients who underwent successful EVT, those with M2 occlusions had significantly higher odds of poor outcome compared to those with M1 occlusions.</p>","PeriodicalId":14380,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251343283"},"PeriodicalIF":1.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}