Department of Radiology, Faculty Hospital Trnava, Trnava, Slovakia.
Department of Neurology, Faculty Hospital Trnava, Trnava, Slovakia.
Interv Neuroradiol. 2020 Aug;26(4):383-388. doi: 10.1177/1591019920925678. Epub 2020 May 12.
The aim of the present study was (i) to evaluate the safety and efficacy of aspiration thrombectomy in patients with M2 occlusions and (ii) to compare outcome of treatment of occlusion of different M2 segments.
Between March 2016 and June 2019, 82 patients with acute ischemic stroke and isolated M2 occlusions were treated in cerebrovascular stroke center with aspiration thrombectomy as the first-line treatment. Functional outcomes of patients with different types of M2 occlusions were statistically compared. Multivariable logistic regression analysis was performed to determine the factors associated with good clinical outcome.
The mean age was 71.9 ± 13.4 years, 47.6% were men. Aspiration thrombectomy alone was utilized in 72.5% of patients, with 27.5% of patients being treated with a combination of aspiration thrombectomy and stent retriever. At the three-month follow-up, there was no statistically significant difference in functional outcome between different types of M2 occlusions (p = 0.662), however in the underpowered analysis because of the small sample size of patients, with good clinical outcome mRS 0-2 in 50% of all treated patients. Symptomatic intracranial hemorrhage was found in 6.1% of patients. Lower age (OR 0.932, 95% CI 0.878-0.988) and lower NIHSS score upon admission (OR 0.893, 95% CI 0.805-0.991) were independent predictors of good clinical outcome.
Aspiration thrombectomy appeared to be a safe and effective first-line treatment option for patients with M2 occlusion, being the first-line option for almost three-quarters of patients.
本研究旨在（i）评估抽吸血栓切除术治疗 M2 闭塞患者的安全性和疗效，（ii）比较不同 M2 段闭塞的治疗结果。
2016 年 3 月至 2019 年 6 月，82 例急性缺血性脑卒中合并孤立性 M2 闭塞患者在脑血管病中心接受抽吸血栓切除术作为一线治疗。对不同类型 M2 闭塞患者的治疗结果进行统计学比较。采用多变量逻辑回归分析确定与良好临床结局相关的因素。
患者平均年龄为 71.9±13.4 岁，47.6%为男性。单纯抽吸血栓切除术应用于 72.5%的患者，27.5%的患者联合应用抽吸血栓切除术和支架取栓术。在 3 个月的随访中，不同类型的 M2 闭塞之间的功能结局无统计学差异（p=0.662），然而由于患者样本量小，该分析效能不足，所有治疗患者中有 50%达到良好临床结局 mRS 0-2。症状性颅内出血发生率为 6.1%。较低的年龄（OR 0.932，95%CI 0.878-0.988）和入院时较低的 NIHSS 评分（OR 0.893，95%CI 0.805-0.991）是良好临床结局的独立预测因素。
抽吸血栓切除术似乎是 M2 闭塞患者安全有效的一线治疗选择，近四分之三的患者将其作为一线选择。
