NYMC Faculty Publications

Incidence and Clinical Outcomes of Perforations During Mechanical Thrombectomy for Medium Vessel Occlusion in Acute Ischemic Stroke: A Retrospective, Multicenter, and Multinational Study

Author Type(s)

Faculty

DOI

10.1177/23969873231219412

Journal Title

European Stroke Journal

First Page

328

Last Page

337

Document Type

Article

Publication Date

6-2024

Department

Neurosurgery

Keywords

Humans, Ischemic Stroke, Male, Retrospective Studies, Female, Aged, Middle Aged, Incidence, Thrombectomy, Treatment Outcome, Aged, 80 and over

Disciplines

Medicine and Health Sciences

Abstract

BACKGROUND: Mechanical thrombectomy (MT) has revolutionized the treatment of acute ischemic stroke (AIS) due to large vessel occlusion (LVO), but its efficacy and safety in medium vessel occlusion (MeVO) remain less explored. This multicenter, retrospective study aims to investigate the incidence and clinical outcomes of vessel perforations (confirmed by extravasation during an angiographic series) during MT for AIS caused by MeVO.

METHODS: Data were collected from 37 academic centers across North America, Asia, and Europe between September 2017 and July 2021. A total of 1373 AIS patients with MeVO underwent MT. Baseline characteristics, procedural details, and clinical outcomes were analyzed.

RESULTS: The incidence of vessel perforation was 4.8% (66/1373). Notably, our analysis indicates variations in perforation rates across different arterial segments: 8.9% in M3 segments, 4.3% in M2 segments, and 8.3% in A2 segments (

CONCLUSION: This study reveals that while the occurrence of vessel perforation in MT for AIS due to MeVO is relatively rare, it is associated with poor functional outcomes and higher mortality. The findings highlight the need for increased caution and specialized training in performing MT for MeVO. Further prospective research is required for risk mitigation strategies.

Comments

Please see the work itself for a complete list of authors.

Link to Full Text

Share

COinS