TY - JOUR T1 - Mechanical thrombectomy in minor stroke due to isolated M2 occlusion: a multicenter retrospective matched analysis JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg DO - 10.1136/jnis-2022-019557 SP - jnis-2022-019557 AU - Andrea M Alexandre AU - Francesca Colò AU - Valerio Brunetti AU - Iacopo Valente AU - Giovanni Frisullo AU - Alessandro Pedicelli AU - Luca Scarcia AU - Claudia Rollo AU - Anne Falcou AU - Luca Milonia AU - Marco Andrighetti AU - Mariangela Piano AU - Antonio Macera AU - Christian Commodaro AU - Maria Ruggiero AU - Valerio Da Ros AU - Luigi Bellini AU - Guido A Lazzarotti AU - Mirco Cosottini AU - Armando A Caragliano AU - Sergio L Vinci AU - Joseph D Gabrieli AU - Francesco Causin AU - Pietro Panni AU - Luisa Roveri AU - Nicola Limbucci AU - Francesco Arba AU - Marco Pileggi AU - Giovanni Bianco AU - Daniele G Romano AU - Francesco Diana AU - Vittorio Semeraro AU - Nicola Burdi AU - Maria P Ganimede AU - Emilio Lozupone AU - Antonio Fasano AU - Elvis Lafe AU - Anna Cavallini AU - Riccardo Russo AU - Mauro Bergui AU - Paolo Calabresi AU - Giacomo Della Marca AU - Aldobrando Broccolini Y1 - 2022/10/12 UR - http://jnis.bmj.com/content/early/2022/10/12/jnis-2022-019557.abstract N2 - 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 0–1.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. ER -