Hypoperfusion Intensity Ratio Predicts Successful Recanalization in M2 MCA Occlusion Stroke Treated with Thrombectomy.
Publication/Presentation Date
8-3-2026
Abstract
BACKGROUND AND PURPOSE: The role of endovascular thrombectomy for acute ischemic stroke due to M2 MCA occlusion remains uncertain, in part because angiographic recanalization rates are lower than those achieved in large-vessel occlusion. The hypoperfusion intensity ratio (HIR), a perfusion-derived marker of collateral physiology, has been associated with infarct evolution and outcomes, but its relationship with the technical success of thrombectomy in M2 occlusion is unknown.
MATERIALS AND METHODS: In this retrospective, multinational study of the Multicenter Analysis of Primary Distal Medium Vessel Occlusions: Effect of Mechanical Thrombectomy (MAD-MT) Consortium registry, patients with M2 MCA occlusion who underwent EVT between September 2017 and July 2023 were included. Multivariable logistic regression analysis for successful EVT (mTICI 2b-3) was performed with HIR alongside demographic and stroke characteristics.
RESULTS: Among 111 patients with M2 MCA occlusion, 23 (21%) had unsuccessful EVT and 88 (79%) had successful EVT. HIR (0.50 [0.00-0.63] versus 0.20 [0.00-0.40],
CONCLUSIONS: This retrospective study suggests that HIR may serve as a predictor of success in EVT and a potentially useful adjunct tool for decision-making in patients who have had MeVO stroke. However, the limited sample size and unmeasured confounders should be considered. These findings underscore the role that perfusion imaging-based quantitative collateral assessments can play in prognosis for these patients.
Volume
47
Issue
8
First Page
2046
Last Page
2054
ISSN
1936-959X
Published In/Presented At
Salim, H. A., Kooshki, A., Lakhani, D. A., Hoseinyazdi, M., Faizy, T. D., Heit, J. J., Liebeskind, D. S., Mei, J., Wolman, D., Albers, G. W., Sriwastwa, A., Cho, A., Guenego, A., Dmytriw, A. A., Yedavalli, V. S., MAD-MT Consortium, MAD-MT Consortium Authors:, & Collaborators (Not Authors) - MAD MT Investigators: (2026). Hypoperfusion Intensity Ratio Predicts Successful Recanalization in M2 MCA Occlusion Stroke Treated with Thrombectomy. AJNR. American journal of neuroradiology, 47(8), 2046–2054. https://doi.org/10.3174/ajnr.A9236
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
41698817
Department(s)
Administration and Leadership
Document Type
Article