Related Experiment Video
Updated: Jul 11, 2026

Embolic Middle Cerebral Artery Occlusion MCAO for Ischemic Stroke with Homologous Blood Clots in Rats
Published on: September 17, 2014
Thrombus migration in emergent M1 middle cerebral artery occlusion
Slaven Pikija1, Monika Killer-Oberpfalzer2, Johannes A R Pfaff3
1Department of Neurology, University Hospital Salzburg, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.
Background And Purpose:
Thrombus migration (TM) is a well-established phenomenon in patients with intracranial vessel occlusion, particularly in those who receive alteplase. However, the relationship between TM, reperfusion success, and clinic-radiological outcomes is still being determined. This study aimed to describe the various outcomes in the event of TM in patients with M1 middle cerebral artery (M1 MCA) occlusion.
Materials And Methods:
The study involved a retrospective analysis of patients undergoing endovascular thrombectomy (EVT) due to M1 MCA occlusion from two tertiary centers between January 2015 and December 2020. The proximal positions of thrombi were measured using a curve tool on CT or MR angiography before EVT. Subsequently, measurements were taken on angiographic imaging. Patients were grouped based on the amount of difference between the two measurements: growth (≤ - 10 mm), stability (> -10 mm and ≤ 10 mm), migration (> 10 mm), and resolution.
Results:
A total of 463 patients (266 [57%] females, median 76 [interquartile range IQR: 65-83] years) were analyzed. Of them, 106 (22.8%) expressed any degree of TM. In multivariate ordinal regression analysis, the alteplase was significantly associated with TM (t = 2.192, p = 0.028), as was the greater interval from first imaging to angiography (t = 2.574, p = 0.010). In multivariate logistical regression analysis, the good clinical outcome measured by the modified Rankin scale (0-2) was not associated with TM status.
Conclusions:
Thrombus migration within the M1 MCA segment occurs in almost a quarter of patients, is associated with alteplase administration, and is mainly irrelevant to radiological and clinical outcome.
Related Concept Videos
Venous Thrombosis I: Introduction
Stroke: Introduction and Types
Ischemic Stroke ll: Pathophysiology
Hemorrhagic Stroke ll: Pathophysiology
Transient Ischemic Attack l: Introduction

