Comparing clinical outcomes in patients with M2 middle cerebral artery segment occlusions of different stroke etiologies who undergo endovascular treatment: A retrospective study

Background

Distal medium vessel occlusion may lead to severe neurological deficits. The aim of this study was to investigate the differences in endovascular treatment (EVT) procedure and their impact on clinical outcomes in patients with different etiologies of the M2 segment of the middle cerebral artery (M2-MCA) occlusion.

Methods

This study was a single center, retrospective analysis of patients with M2-MCA occlusion treated with EVT. Patients were divided into atherosclerosis group and embolization group, and we determined the etiology of stroke based on the imaging features during EVT. Procedure-related outcomes included treatment modalities, degree of recanalization, and procedural complications. Clinical outcomes included the good outcome (modified Rankin Scale score 0–2) at 90 days, incidence of symptomatic intracranial hemorrhage (sICH) and any intracranial hemorrhage within 24 h, and mortality at 90 days.

Results

A total of 81 patients were included, and the numbers of patients in the atherosclerosis and embolization groups were 20 and 61, respectively. In the embolization group, patients were treated with a higher number of mechanical thrombectomies (2 [1–3] vs 1 [1,2], P = 0.028). However, the proportion of patients treated with rescue therapy (50.0 % vs 1.6 %, P＜0.001) were significantly greater in the atherosclerosis group. The degree of recanalization and incidence of procedural complications were not significantly different between the two groups. There was also no statistical difference in the four clinical outcomes between the two groups.

Conclusion

Specific approaches to EVT differ for patients with M2-MCA occlusion of different etiologies. However, there were no significant differences in recanalization rates, procedural complications, or clinical outcomes.