TY - JOUR T1 - Influence of prior intravenous thrombolysis in patients treated with mechanical thrombectomy for M2 occlusions: insight from the Endovascular Treatment in Ischemic Stroke (ETIS) registry JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg DO - 10.1136/jnis-2022-019672 SP - jnis-2022-019672 AU - Agathe Le Floch AU - Frédéric Clarençon AU - Aymeric Rouchaud AU - Maeva Kyheng AU - Julien Labreuche AU - Igor Sibon AU - Gregoire Boulouis AU - Benjamin Gory AU - Sébastien Richard AU - Jildaz Caroff AU - Raphaël Blanc AU - Pierre Seners AU - Omer F Eker AU - Tae-Hee Cho AU - Arturo Consoli AU - Romain Bourcier AU - benoit guillon AU - Cyril Dargazanli AU - Caroline Arquizan AU - Christian Denier AU - Francois Eugene AU - Stephane Vannier AU - Jean-Christophe Gentric AU - Maxime Gauberti AU - Olivier Naggara AU - Charlotte Rosso AU - Guillaume Turc AU - Ozlem Ozkul-Wermester AU - Christophe Cognard AU - Jean François Albucher AU - Serge Timsit AU - Frederic Bourdain AU - Anthony Le Bras AU - Sebastian Richter AU - Solène Moulin AU - Raoul Pop AU - Olivier Heck AU - Ricardo Moreno AU - Vincent L'Allinec AU - Bertrand Lapergue AU - Gaultier Marnat A2 - , Y1 - 2022/12/02 UR - http://jnis.bmj.com/content/early/2022/12/01/jnis-2022-019672.abstract N2 - Background Intravenous thrombolysis (IVT) for patients treated with mechanical thrombectomy (MT) for proximal occlusions has recently been questioned through randomized trials. However, few patients with M2 occlusions were included. We investigated the influence of prior IVT for patients presenting M2 occlusions treated with MT in comparison with MT alone.Methods We conducted a retrospective analysis of the Endovascular Treatment in Ischemic Stroke (ETIS) registry, a multicenter observational study. Data from consecutive patients treated with MT for M2 occlusions between January 2015 and January 2022 at 26 comprehensive stroke centers were analyzed. The primary endpoint was 90-day modified Rankin Scale score of 0–2. Outcomes were compared using propensity score approaches. We also performed sensitivity analysis in relevant subgroups of patients.Results Among 1132 patients with M2 occlusions treated with MT, 570 received prior IVT. The two groups were comparable after propensity analysis. The rate of favorable functional outcome was significantly higher in the IVT+MT group compared with the MT alone group (59.8% vs 44.7%; adjusted OR 1.38, 95% CI 1.10 to 1.75, P=0.008). Hemorrhagic and procedural complications were similar in both groups. In sensitivity analysis excluding patients with anticoagulation treatment, favorable recanalization was more frequent in the IVT+MT group (OR 1.37, 95% CI 1.11 to 1.70, P=0.004).Conclusions In cases of M2 occlusions, prior IVT combined with MT resulted in better functional outcome than MT alone, without increasing the rate of hemorrhagic or procedural complications. These results suggest the benefit of IVT in patients undergoing MT for M2 occlusions.Data are available upon reasonable request. The data used in this study are available from the corresponding author upon reasonable request. ER -