RT Journal Article
SR Electronic
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
FD BMJ Publishing Group Ltd.
SP jnis-2022-019557
DO 10.1136/jnis-2022-019557
A1 Andrea M Alexandre
A1 Francesca Colò
A1 Valerio Brunetti
A1 Iacopo Valente
A1 Giovanni Frisullo
A1 Alessandro Pedicelli
A1 Luca Scarcia
A1 Claudia Rollo
A1 Anne Falcou
A1 Luca Milonia
A1 Marco Andrighetti
A1 Mariangela Piano
A1 Antonio Macera
A1 Christian Commodaro
A1 Maria Ruggiero
A1 Valerio Da Ros
A1 Luigi Bellini
A1 Guido A Lazzarotti
A1 Mirco Cosottini
A1 Armando A Caragliano
A1 Sergio L Vinci
A1 Joseph D Gabrieli
A1 Francesco Causin
A1 Pietro Panni
A1 Luisa Roveri
A1 Nicola Limbucci
A1 Francesco Arba
A1 Marco Pileggi
A1 Giovanni Bianco
A1 Daniele G Romano
A1 Francesco Diana
A1 Vittorio Semeraro
A1 Nicola Burdi
A1 Maria P Ganimede
A1 Emilio Lozupone
A1 Antonio Fasano
A1 Elvis Lafe
A1 Anna Cavallini
A1 Riccardo Russo
A1 Mauro Bergui
A1 Paolo Calabresi
A1 Giacomo Della Marca
A1 Aldobrando Broccolini
YR 2022
UL http://jnis.bmj.com/content/early/2022/10/12/jnis-2022-019557.abstract
AB 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.