Occlusion Location of Middle Cerebral Artery Stroke and Outcome after Endovascular Treatment.

Arnold, Marcel; Slezak, Agnieszka Anna; El-Koussy, Marwan; Lüdi, Rudolf; Findling, Oliver; Mono, Marie-Luise; Heldner, Mirjam Rachel; Fischer, Urs; Mordasini, Pasquale; Schroth, Gerhard; Mattle, Heinrich; Gralla, Jan; Jung, Simon (2015). Occlusion Location of Middle Cerebral Artery Stroke and Outcome after Endovascular Treatment. European neurology, 74(5-6), pp. 315-321. Karger 10.1159/000441445

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BACKGROUND The aim of this study was to analyze the influence of the location of middle cerebral artery (MCA) occlusion on recanalization, complications and outcome after endovascular therapy. METHODS Four-hundred sixty-four patients with acute MCA occlusions were treated with endovascular therapy. RESULTS Two-hundred ninety-three patients had M1 occlusions, 116 had M2, and 55 had M3/4 occlusions. Partial or complete recanalization was more frequently achieved in M1 (76.8%) than in M2 (59.1%) or M3/4 (47.3%, p < 0.001) occlusions, but favorable outcome (modified Rankin Scale 0-2) was less frequent in M1 (50.9%) than M2 (63.7%) or M3/4 (72.7%, p = 0.018) occlusions. Symptomatic intracerebral hemorrhage (ICH) did not differ between occlusion sites, but asymptomatic ICH was more common in M1 (22.6%) than in M2 occlusions (8.6%, p = 0.003). Recanalization was associated with favorable outcome in M1 (p < 0.001) and proximal M2 (p = 0.003) but not in distal M2 or M3/4 occlusions. CONCLUSIONS Recanalization with endovascular therapy was more frequently achieved in patients with proximal than distal MCA occlusions, but recanalization was associated with favorable outcome only in M1 and proximal M2 occlusions. Outcome was better with distal than proximal occlusions. This study shows that recanalization can be used as a surrogate marker for clinical outcome only in patients with proximal occlusions.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Arnold, Marcel; Slezak, Agnieszka Anna; El-Koussy, Marwan; Lüdi, Rudolf; Findling, Oliver; Mono, Marie-Luise; Heldner, Mirjam Rachel; Fischer, Urs; Mordasini, Pasquale; Mattle, Heinrich; Gralla, Jan and Jung, Simon

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0014-3022

Publisher:

Karger

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

13 Jan 2016 17:06

Last Modified:

19 Dec 2016 02:30

Publisher DOI:

10.1159/000441445

PubMed ID:

26678266

BORIS DOI:

10.7892/boris.74582

URI:

https://boris.unibe.ch/id/eprint/74582

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