Background: Mechanical thrombectomy (MT) is established as an effective treatment for large vessel occlusion strokes, but its efficacy and safety for medium vessel occlusions (MeVOs) remain less clear. This study examines the impact of periprocedural embolization to a new vascular territory (ENT) on clinical outcomes in patients with MeVO stroke treated with MT.
Methods: A multicenter, retrospective analysis was conducted using the MAD-MT (Multicenter Analysis of primary Distal medium vessel occlusions: effect of Mechanical Thrombectomy) registry, including 2122 patients with MeVO stroke w-ho underwent MT between September 2017 and July 2023. ENT was defined as filling defects in previously unaffected territories, excluding embolization near the original occlusion, observed on final angiographic runs after retrieval of the primary thrombus. The associations between ENT, procedural variables, and 90-day clinical outcomes were evaluated, including functional independence (modified Rankin Scale (mRS) scores of 0-2), excellent outcomes (mRS 0-1), mortality, and hemorrhagic complications.
Results: ENT occurred in 2.9% (63/2122) of patients. Longer onset-to-arterial puncture time (adjusted OR 1.03; 95% CI 1.01 to 1.05; P=0.002) and a greater number of passes (adjusted OR 1.15; 95% CI 1.01 to 1.32; P=0.032) were associated with increased ENT risk, while excellent recanalization (thrombolysis in cerebral infarction (TICI) scale score 2c-3) was associated with reduced ENT risk (adjusted OR 0.41; 95% CI 0.23 to 0.72; P=0.002). ENT was not associated with poorer functional independence, mortality, or hemorrhagic complications.
Conclusions: ENT during MT for MeVO stroke occurs infrequently and does not significantly affect the clinical outcomes. These findings suggest ENT risk should not deter clinicians from performing MT in patients with MeVO. Further prospective studies are needed to validate these results.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1136/jnis-2024-022570 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Idiopathic polyarteritis nodosa-does it still exist? Viewpoint 2: idiopathic polyarteritis nodosa is rare, but still exists.
Rheumatology (Oxford)
March 2025
Division of Rheumatology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Altindag, Ankara, Türkiye.
Polyarteritis Nodosa (PAN), is the firstly described vasculitis and can be seen in paediatric and adult age. PAN has a heterozygous clinical picture including cutaneous, constitutional, musculoskeletal, gastrointestinal, and renal involvement. Description and splitting of other vasculitis, makes this medium vessel vasculitis, a very rare disease.
View Article and Find Full Text PDFAssociations of fundus tessellation, myopic diffuse chorioretinal atrophy and choroidal thickness with visual acuity in myopia.
Acta Ophthalmol
March 2025
Beijing Visual Science and Translational Eye Research Institute (BERI), Eye Center of Beijing Tsinghua Changgung Hospital, Tsinghua Medicine, Tsinghua University, Beijing, China.
Purpose: To explore associations between stages of myopic macular degeneration (MMD) and visual acuity and influencing parameters.
Methods: Participants of the population-based study Beijing Eye Study (n = 3468 participants) underwent a detailed ocular and systemic examination.
Results: Assessable images were available for 3040 (87.
Aseptic meningitis in the setting of giant cell arteritis (GCA): a case report.
BMC Rheumatol
March 2025
Department of Medicine, Albury-Wodonga Health, Albury, NSW, Australia.
Background: Giant cell arteritis (GCA) is a vasculitis primarily affecting medium- and large-sized arteries. The diagnosis may be challenging and lead to delays in treatment. Cerebrospinal fluid (CSF) pleocytosis is an uncommon association but may occur due to central nervous system (CNS) vasculitis or pachymeningitis.
View Article and Find Full Text PDFSegmental arterial mediolysis with subarachnoid hemorrhage following chronic internal carotid artery dissection: illustrative case.
J Neurosurg Case Lessons
March 2025
Department of Neurosurgery, Chuno Kosei Hospital, Seki, Japan.
Background: Segmental arterial mediolysis (SAM) is a rare, noninflammatory vascular disease primarily affecting small to medium arteries. Although neurological presentations like subarachnoid hemorrhage (SAH) and ischemic stroke have been reported, awareness of SAM in neurology remains limited. The authors present a unique case of SAM with SAH following chronic internal carotid artery (ICA) dissection and explore the clinical course and potential ethnic implications of the disease.
View Article and Find Full Text PDFCT-based multi-regional radiomics model for predicting contrast medium extravasation in patients with tumors: A case-control study.
PLoS One
March 2025
Department of Radiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China.
Objective: To develop a non-contrast CT based multi-regional radiomics model for predicting contrast medium (CM) extravasation in patients with tumors.
Methods: A retrospective analysis of non-contrast CT scans from 282 tumor patients across two medical centers led to the development of a radiomics model, using 157 patients for training, 68 for validation, and 57 from an external center as an independent test cohort. The different volumes of interest from right common carotid artery/right internal jugular vein, right subclavian artery/vein and thoracic aorta were delineated.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!