Predictors and Outcomes of Excellent Recanalization Versus Successful Recanalization After Thrombectomy in Proximal and Distal Medium Vessel Occlusion Strokes: A Multinational Study.
Publication/Presentation Date
11-1-2024
Abstract
BACKGROUND: Acute ischemic stroke arising from medium vessel occlusions (MeVO) poses substantial challenges in treatment and management. This study aims to elucidate the outcomes and factors contributing to achieving excellent recanalization (modified Thrombolysis in Cerebral Infarction [mTICI] 2c-3) versus successful recanalization (mTICI 2b) in patients with MeVO stroke undergoing mechanical thrombectomy (MT).
METHODS: We conducted a multinational study analyzing data from the MAD-MT (Multicenter Analysis of Distal Medium Vessel Occlusions: Effect of Mechanical Thrombectomy) registry, encompassing 37 centers across North America, Asia, and Europe, collected between September 2017 and July 2023. The study included acute ischemic stroke patients with MeVO treated with MT, with or without intravenous thrombolysis, who achieved mTICI 2b-3 post-MT.
RESULTS: Among 1463 patients with successful recanalization (mTICI 2b-3), 523 achieved mTICI 2b recanalization, and 940 achieved mTICI 2c-3. Distal occlusions exhibited higher odds of excellent recanalization compared with proximal MeVO vessel occlusions (odds ratio, 1.58; 95% CI, 1.17-2.15;
CONCLUSION: This study underscores that among patients with MeVO stroke with successful recanalization (mTICI 2b-3) there is higher likelihood of achieving excellent recanalization (mTICI 2c-3) in distal occlusions and cardioembolic pathogenesis. mTICI 2c-3 scores post-MT correlate with improved clinical outcomes compared with mTICI 2b, affirming the superiority of excellent recanalization over successful recanalization in patients with MeVO stroke. Further prospective studies and randomized controlled trials are warranted for validation.
Volume
4
Issue
6
First Page
001421
Last Page
001421
ISSN
2694-5746
Published In/Presented At
Yedavalli, V., Salim, H. A., Musmar, B., Adeeb, N., Naamani, K. E., Henninger, N., Sundararajan, S. H., Kühn, A. L., Khalife, J., Ghozy, S., Scarcia, L., Tan, B. Y. Q., Heit, J. J., Regenhardt, R. W., Cancelliere, N. M., Bernstock, J. D., Rouchaud, A., Fiehler, J., Sheth, S., Essibayi, M. A., … MAD MT Investigators (2024). Predictors and Outcomes of Excellent Recanalization Versus Successful Recanalization After Thrombectomy in Proximal and Distal Medium Vessel Occlusion Strokes: A Multinational Study. Stroke (Hoboken, N.J.), 4(6), e001421. https://doi.org/10.1161/SVIN.124.001421
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
41583405
Department(s)
Administration and Leadership
Document Type
Article