AI Article Synopsis

  • Mechanical thrombectomy (MT) has been studied for its effectiveness in treating distal medium vessel occlusions (DMVO) in acute stroke patients, but clear evidence of its clinical benefits is limited.
  • In a study of 138 patients, those who underwent MT showed a trend towards greater improvement in neurological function compared to those who received standard medical therapy (SMT), although the differences in safety outcomes like hemorrhage and mortality were not significant.
  • Successful MT (achieving a certain level of blood flow restoration) was linked to better clinical outcomes, indicating that while MT appears safe and potentially beneficial, further research through larger studies is needed to confirm these results.

Article Abstract

Mechanical thrombectomy (MT) is frequently performed for distal medium vessel occlusions (DMVO) of the anterior circulation in acute stroke patients. However, evidence for its clinical benefit remains scarce. In this study, we aim to investigate clinical course and safety outcomes of MT in comparison to standard medical therapy (SMT) in DMVO. This single-center retrospective observational study included 138 consecutive patients treated for DMVO of the anterior circulation between 2015 and 2021. To reduce the risk of selection bias, propensity score matching (PSM) of patients with MT versus SMT was performed for the covariates NIHSS and mRS at admission. Out of all 138 patients, 48 (34.8%) received MT and 90 (65.2%) received SMT only. Overall, patients treated with MT showed significantly higher NIHSS and mRS scores at admission. Post 1:1 PSM, there was a trend toward a better NIHSS improvement in patients with MT (median 4 vs. 1, P = 0.1). No significant differences were observed in the occurrence of symptomatic intracranial hemorrhage or mortality between the groups before and after PSM. A subgroup analysis showed significantly higher NIHSS improvement (median 5 versus 1, P = 0.01) for patients with successful MT (≥ mTICI 2b). Mechanical thrombectomy for distal medium vessel occlusions (DMVO) in the anterior circulation appeared safe and feasible. Successful recanalization was associated with clinical improvement. Larger, multi-center, randomized-controlled trials are required to corroborate these findings.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10082188PMC
http://dx.doi.org/10.1038/s41598-023-32634-0DOI Listing

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