| Incomplete mechanical recanalization of middle cerebral artery occlusions facilitates endogenous recanalization within 5 h. | |
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MedLine Citation:
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PMID: 22315286 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background and purposeSuccessful revascularization can often improve functional outcome after large intracranial arterial occlusions. However, incomplete or unsuccessful recanalization is often the end result after attempted mechanical thrombectomy. A study was undertaken to determine whether partial recanalization of proximal isolated middle cerebral artery (MCA) occlusions facilitates endogenous thrombolysis and spontaneous recanalization.MethodsWe retrospectively analyzed consecutive patients with acute ischemic stroke undergoing mechanical thrombectomy using the Merci Retriever System for occlusions involving any portion of the M1 segment of the MCA. Only those patients with a residual obstruction of the proximal MCA segments were included. The rates of facilitated endogenous recanalization (FER(5)) by imaging within the 5 h following intervention were compared in patients with partial proximal recanalization and those in whom recanalization was unsuccessful.ResultsForty-two patients were included in the analysis. Twenty-six patients had good recanalization of the proximal aspect of the target lesion with an arterial occlusive lesion score of 2 or 3 but a residual partial or total occlusion of the MCA, while 16 patients failed to recanalize any portion of the target occlusion. Twelve patients (46%) in the first group and only one (5.9%) in the second group had facilitated endogenous recanalization on interval imaging 5 h after intervention (OR 12.9, 95% CI 1.5 to 112.2). Nine patients with proximal recanalization had good clinical outcomes at discharge (mRS ≤2) compared with none without recanalization (p=0.01), but FER did not have a relationship with clinical outcome.ConclusionsDespite initially incomplete proximal mechanical thrombectomy, nearly half of all patients with residual M1 occlusions will undergo further endogenous recanalization within the subsequent 5 h. |
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Authors:
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Yince Loh; Zhongsong Shi; David Liebeskind; Reza Jahan; Nestor Gonzalez; Paul M Vespa; Sidney Starkman; Jeffrey L Saver; Satoshi Tateshima; Fernando Vinuela; Gary Duckwiler |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-2-7 |
Journal Detail:
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Title: Journal of neurointerventional surgery Volume: - ISSN: 1759-8486 ISO Abbreviation: - Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-2-8 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101517079 Medline TA: J Neurointerv Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Medicine, Madigan Army Medical Center, Tacoma, Washington, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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