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Updated: Jun 26, 2026
Embolic Middle Cerebral Artery Occlusion (MCAO) for Ischemic Stroke with Homologous Blood Clots in Rats
Published on: September 17, 2014
Outcome predictors of open embolectomy in middle cerebral artery occlusion
Tetsuyoshi Horiuchi1, Junpei Nitta, Toshihiro Ogiwara
1Department of Neurosurgery, Shinshu University School of Medicine, Asahi, Matsumoto, Japan. tetuyosi@shinshu-u.ac.jp
Objective:
The purpose of this paper was to analyse the outcome of the patients with acute middle cerebral artery (MCA) occlusion treated by open embolectomy.
Methods:
A clinical chart review was retrospectively conducted for 30 patients who had MCA occlusion and were treated with open embolectomy. According to the Glasgow Outcome Scale, the patients' outcome at discharge is divided in two groups: favorable outcome (good recovery and moderate disability) or unfavorable outcome (severe disability, vegetative state and death). The following variables between the favorable and unfavorable outcomes were analysed: age, sex, Glasgow Coma Scale score on admission, affected side, occlusion site, occlusion time, atrial fibrillation on electrocardiogram, fibrinolysis, aphasia, hemiparesis and hemorrhagic infarction after surgery.
Results:
The outcomes of 30 patients were favorable in 16 patients (good recovery in nine and moderate disability in seven) and unfavorable in 14 patients (severe disability in 12, vegetative state in one and death in one). The M1 occlusion and fibrinolysis performance were more frequent in the unfavorable outcome group than in the favorable one. Logistic regression analysis with a stepwise method indicated that the only occlusion site was independently associated with the unfavorable outcome. The occlusion time >360 minutes was not the predictor of the unfavorable outcome.
Discussion:
The outcome of patients with MCA occlusion treated by the open embolectomy depends on the occlusion site and the fibrinolysis performance in the present study. The M1 occlusion is also the independent risk factor of the unfavorable outcome. However, the occlusion time itself has no relation to the unfavorable outcome. These results indicate that therapeutic time windows vary in individuals probably due to the collateral blood flow.
Insights
Open embolectomy for acute middle cerebral artery (MCA) occlusion shows outcomes depend on occlusion site, not just time. M1 occlusion is a key risk factor for poor results in stroke patients.
Area of Science:
- Neurology
- Neurosurgery
- Vascular Surgery
Background:
- Acute ischemic stroke due to middle cerebral artery (MCA) occlusion requires timely and effective treatment.
- Open embolectomy is a surgical intervention used to remove blood clots from occluded cerebral arteries.
Purpose of the Study:
- To analyze the outcomes of patients with acute MCA occlusion treated with open embolectomy.
- To identify factors associated with favorable or unfavorable outcomes.
Main Methods:
- Retrospective chart review of 30 patients undergoing open embolectomy for MCA occlusion.
- Outcomes assessed using the Glasgow Outcome Scale (favorable vs. unfavorable).
- Analysis of variables including age, GCS, occlusion site, time, fibrinolysis, and post-operative complications.
Main Results:
- 16 out of 30 patients had favorable outcomes, while 14 had unfavorable outcomes.
- M1 occlusion and fibrinolysis were more common in the unfavorable outcome group.
- Logistic regression identified occlusion site as the sole independent predictor of unfavorable outcomes; occlusion time >360 minutes was not significant.
Conclusions:
- Occlusion site and fibrinolysis performance influence outcomes in MCA occlusion treated by open embolectomy.
- M1 occlusion is an independent risk factor for unfavorable outcomes.
- Therapeutic time windows may be individual-dependent, potentially due to collateral circulation.
