Treatment outcomes of successful M1 versus M2 thrombectomy for low-ASPECTS stroke patients.

Authors

• Huanwen Chen
• Marco Colasurdo
• Hidetoshi Matsukawa
• Conor Cunningham
• Ilko Maier
• Pascal Jabbour
• Joon-Tae Kim
• Stacey Quintero Wolfe
• Ansaar Rai
• Robert M Starke
• Marios-Nikos Psychogios
• Amir Shaban
• Nitin Goyal
• Shinichi Yoshimura
• Hugo Cuellar
• Brian Howard
• Ali Alawieh
• Ali Alaraj
• Mohamad Ezzeldin
• Daniele G Romano
• Omar Tanweer
• Justin Mascitelli
• Isabel Fragata
• Adam Polifka
• Fazeel Siddiqui
• Joshua Osbun
• Roberto Crosa
• Ramesh Grandhi
• Charles Matouk
• Min S Park
• Michael R Levitt
• Waleed Brinjikji
• Mark Moss
• Ergun Daglioglu
• Richard Williamson
• Pedro Navia
• Shakeel Chowdhry
• David J Altschul
• Alejandro M Spiotta
• Peter Kan

Publication/Presentation Date

6-18-2025

Abstract

BackgroundThe effectiveness of endovascular thrombectomy (EVT) for low Alberta Stroke Program Early CT score (ASPECTS) stroke patients with occlusion of the second segment of the middle cerebral artery (M2) is unclear.MethodsThis was a multicenter retrospective study. Patients with M1 or M2 occlusions and low ASPECTS (< 6) who underwent successful EVT (modified treatment in cerebral ischemia score of 2b or higher) were included. Primary outcome was futile EVT reperfusion (defined as 90-day modified Rankin scale of 5 or 6). Other outcomes of interest include acceptable outcomes (modified Rankin scale of 3 or less) and intracranial hemorrhage (ICH), and all-cause 90-day mortality. Outcomes for M1 patients were compared to M2 patients with multivariable logistic regression models accounting for potential confounders.Results173 patients with M1 or M2 occlusions and low ASPECTS (< 6) who underwent successful EVT were identified. After multivariable adjustments, M2 patients had significantly higher odds of futile reperfusion (OR 5.48 [95%CI 1.91 to 15.7], p = 0.002), lower odds of acceptable outcomes (OR 0.33 [95%CI 0.12 to 0.89], p = 0.028), and higher odds of all-cause mortality (OR 4.90 [95%CI 1.65 to 14.5], p = 0.004). These findings suggest that EVT's efficacy for low-ASPECTS stroke patients may be diminished for patients with M2 occlusions. M2 occlusion was not significantly associated with ICH.ConclusionsAmong low-ASEPCTS stroke patients who underwent successful EVT, those with M2 occlusions had significantly higher odds of poor outcome compared to those with M1 occlusions.

First Page

15910199251343283

Last Page

15910199251343283

ISSN

2385-2011

Published In/Presented At

Chen, H., Colasurdo, M., Matsukawa, H., Cunningham, C., Maier, I., Jabbour, P., Kim, J. T., Wolfe, S. Q., Rai, A., Starke, R. M., Psychogios, M. N., Shaban, A., Goyal, N., Yoshimura, S., Cuellar, H., Howard, B., Alawieh, A., Alaraj, A., Ezzeldin, M., Romano, D. G., … Kan, P. (2025). Treatment outcomes of successful M1 versus M2 thrombectomy for low-ASPECTS stroke patients. Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, 15910199251343283. Advance online publication. https://doi.org/10.1177/15910199251343283

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

40530425

Department(s)

Administration and Leadership

Document Type

Article