Journal article

Benefit of endovascular thrombectomy for M2 middle cerebral artery occlusion in the ARISE II study.

  • de Havenon A Department of Neurology, University of Utah, Salt Lake City, Utah, USA.
  • Narata AP Service of Radiology and Neuroradiology, University Hospital of Tours, Tours, France.
  • Amelot A Department of Neurosurgery, CHU Tours, Tours, France.
  • Saver JL Department of Neurology, UCLA, Los Angeles, California, USA.
  • Bozorgchami H Oregon Health and Science University, Portland, Oregon, USA.
  • Mattle HP Department of Neurology, Inselspital, University of Bern, Bern, Switzerland.
  • Ribo M Stroke Unit, Neurology, Hospital Vall d'Hebron, Barcelona, Spain.
  • Andersson T Departments of Radiology and Neurology, AZ Groeninge, Kortrijk, Belgium.
  • Zaidat OO Mercy Health St Vincent Medical Center, Toledo, Ohio, USA ozaidat@hotmail.com.
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  • 2020-11-21
Published in:
  • Journal of neurointerventional surgery. - 2020
English BACKGROUND
The benefit of endovascular thrombectomy for acute ischemic stroke with M2 segment middle cerebral artery occlusion remains controversial, with uncertainty and paucity of data specific to this population.


OBJECTIVE
To compare outcomes between M1 and M2 occlusions in the Analysis of Revascularization in Ischemic Stroke with EmboTrap (ARISE II) trial.


METHODS
We performed a prespecified analysis of the ARISE II trial with the primary outcome of 90-day modified Rankin Scale score of 0-2, which we termed good outcome. Secondary outcomes included reperfusion rates and major adverse events. The primary predictor was M2 occlusion, which we compared with M1 occlusion.


RESULTS
We included 183 patients, of whom 126 (69%) had M1 occlusion and 57 (31%) had M2 occlusion. There was no difference in the reperfusion rates or adverse events between M2 and M1 occlusions. The rate of good outcome was not different in M2 versus M1 occlusions (70.2% vs 69.7%, p=0.946). In a logistic regression model adjusted for age, sex, and baseline National Institutes of Health Stroke Scale score, M2 occlusions did not have a significantly different odds of good outcome compared with M1 occlusions (OR 0.94, 95% CI 0.47 to 1.88, p=0.87).


CONCLUSION
In ARISE II, M2 occlusions achieved a 70.2% rate of good outcome at 90 days, which is above published rates for untreated M2 occlusions and superior to prior reports of M2 occlusions treated with endovascular thrombectomy. We also report similar rates of good outcome, successful reperfusion, death, and other adverse events when comparing the M1 and M2 occlusions.
Language
  • English
Open access status
hybrid
Identifiers
Persistent URL
https://sonar.ch/global/documents/222536
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