M1, M2: Time to Bid Adieu!

Area of Science:

• Neuroendovascular treatment
• Acute ischemic stroke
• Cerebrovascular diseases

Background:

• Limited data exists on occlusions in terminal middle cerebral artery divisions and lateral sulcus branches.
• Current practice groups these as M2 segment lesions, hindering specific analysis.
• This lack of granular data impedes progress in transcatheter thrombectomy.

Purpose of the Study:

• To propose an alternative, clinically relevant anatomic characterization for middle cerebral artery terminal occlusions.
• To facilitate more precise reporting of endovascular treatment outcomes.
• To address the knowledge gap in treating these specific stroke locations.

Main Methods:

• Review of existing literature and imaging data.
• Development of a new classification system based on distinct anatomical landmarks.
• Proposal for its application in reporting endovascular stroke treatment results.

Main Results:

• A novel classification system for middle cerebral artery terminal occlusions is presented.
• This system utilizes readily available anatomical features for clinical relevance.
• It offers a more detailed approach than the current M2 segment grouping.

Conclusions:

• The proposed anatomic classification can improve data granularity for stroke occlusions.
• Adoption of this system could enhance understanding of transcatheter thrombectomy efficacy.
• This approach aims to fill critical knowledge gaps in cerebrovascular research.