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Permanent Cerebral Vessel Occlusion via Double Ligature and Transection
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Secondary Medium Vessel Occlusions: When Clots Move North

Mayank Goyal1,2, Manon Kappelhof1,3, Rosalie McDonough4

  • 1Department of Clinical Neurosciences (M.G., M.K., J.M.O.), University of Calgary, Canada.

Stroke
|January 20, 2021
PubMed

Insights

Secondary medium vessel occlusions (MeVOs) in acute ischemic stroke are emerging as a critical area. Understanding their unique characteristics is vital for optimizing treatment and improving patient outcomes in endovascular therapy.

Area of Science:

  • Neurology
  • Interventional Neurology
  • Stroke Medicine

Background:

  • Medium vessel occlusions (MeVOs) are increasingly targeted for endovascular treatment in acute ischemic stroke.
  • MeVOs are not uniform; primary MeVOs arise de novo, while secondary MeVOs result from large vessel occlusions.
  • Limited data exist on the prevalence, management, and prognosis of secondary MeVOs.

Purpose of the Study:

  • To describe the different types of secondary MeVOs.
  • To outline imaging findings associated with secondary MeVOs.
  • To discuss diagnostic challenges and implications for treatment strategies and outcomes.

Main Methods:

  • Review and description of secondary MeVOs.
  • Analysis of imaging findings.
  • Discussion of clinical implications for treatment and outcomes.

Main Results:

  • Secondary MeVOs arise from large vessel occlusions via clot migration or fragmentation.
  • These can occur spontaneously or after thrombolysis/endovascular treatment.
  • Secondary MeVOs present unique diagnostic challenges and impact treatment strategies.

Conclusions:

  • Secondary MeVOs are an under-recognized entity in acute ischemic stroke.
  • Further research is needed to understand their prevalence, management, and prognosis.
  • Recognizing secondary MeVOs is crucial as endovascular treatment indications expand.
Keywords:
acute ischemic strokeangiographyprognosis

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