@article {Alexandrejnis-2022-019557, author = {Andrea M Alexandre and Francesca Col{\`o} and Valerio Brunetti and Iacopo Valente and Giovanni Frisullo and Alessandro Pedicelli and Luca Scarcia and Claudia Rollo and Anne Falcou and Luca Milonia and Marco Andrighetti and Mariangela Piano and Antonio Macera and Christian Commodaro and Maria Ruggiero and Valerio Da Ros and Luigi Bellini and Guido A Lazzarotti and Mirco Cosottini and Armando A Caragliano and Sergio L Vinci and Joseph D Gabrieli and Francesco Causin and Pietro Panni and Luisa Roveri and Nicola Limbucci and Francesco Arba and Marco Pileggi and Giovanni Bianco and Daniele G Romano and Francesco Diana and Vittorio Semeraro and Nicola Burdi and Maria P Ganimede and Emilio Lozupone and Antonio Fasano and Elvis Lafe and Anna Cavallini and Riccardo Russo and Mauro Bergui and Paolo Calabresi and Giacomo Della Marca and Aldobrando Broccolini}, title = {Mechanical thrombectomy in minor stroke due to isolated M2 occlusion: a multicenter retrospective matched analysis}, elocation-id = {jnis-2022-019557}, year = {2022}, doi = {10.1136/jnis-2022-019557}, publisher = {British Medical Journal Publishing Group}, abstract = {Background The purpose of this study was to evaluate the effectiveness of mechanical thrombectomy (MT) in patients with isolated M2 occlusion and minor symptoms and identify possible baseline predictors of clinical outcome.Methods The databases of 16 high-volume stroke centers were retrospectively screened for consecutive patients with isolated M2 occlusion and a baseline National Institutes of Health Stroke Scale (NIHSS) score <=5 who received either early MT (eMT) or best medical management (BMM) with the possibility of rescue MT (rMT) on early neurological worsening. Because our patients were not randomized, we used propensity score matching (PSM) to estimate the treatment effect of eMT compared with the BMM/rMT. The primary clinical outcome measure was a 90-day modified Rankin Scale score of 0{\textendash}1.Results 388 patients were initially selected and, after PSM, 100 pairs of patients receiving eMT or BMM/rMT were available for analysis. We found no significant differences in clinical outcome and in safety measures between patients receiving eMT or BMM/rMT. Similar results were also observed after comparison between eMT and rMT. Concerning baseline predicting factors of outcome, the involvement of the M2 inferior branch was associated with a favorable outcome.Conclusion Our multicenter retrospective analysis has shown no benefit of eMT in minor stroke patients with isolated M2 occlusion over a more conservative therapeutic approach. Although our results must be viewed with caution, in these patients it appears reasonable to consider BMM as the first option and rMT in the presence of early neurological deterioration.Data are available upon reasonable request.}, issn = {1759-8478}, URL = {https://jnis.bmj.com/content/early/2022/10/12/jnis-2022-019557}, eprint = {https://jnis.bmj.com/content/early/2022/10/12/jnis-2022-019557.full.pdf}, journal = {Journal of NeuroInterventional Surgery} }