Endovascular treatment for M3 occlusions.

Area of Science:

• Neurology
• Interventional Neuroradiology
• Vascular Surgery

Background:

• Large vessel occlusions (M1-2) of the middle cerebral artery have high mortality and disability rates if untreated.
• While M3 occlusions have lower rates, significant branch blockages can still lead to disability.
• Endovascular treatment (ET) for small vessel occlusions, including M3, is challenging, with limited existing studies on its effectiveness.

Purpose of the Study:

• To assess the feasibility, safety, and preliminary efficacy of endovascular therapy (ET) for M3 occlusions.
• To evaluate reperfusion rates and clinical outcomes in patients undergoing ET for M3 occlusions.

Main Methods:

• Retrospective analysis of prospectively collected data from two centers (July 2015 - April 2020).
• Included patients with acute ischemic stroke of the anterior circulation treated with ET.
• Collected demographic, radiologic, procedural, and outcome variables.

Main Results:

• Complete or near-complete reperfusion (mTICI 2b-3) was achieved in 38.5% of M3 occlusions.
• Complete reperfusion (mTICI 3) was achieved in 61.5% of cases.
• One case of intracranial hemorrhage (ICH) occurred in primary M3 occlusion treatment, with a normal neurological examination at one month.

Conclusions:

• Endovascular treatment (ET) for M3 occlusions is demonstrated to be safe.
• ET is effective in achieving reperfusion for M3 occlusions.
• The findings suggest ET is a reliable treatment option for M3 occlusions.