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20.02.2019 | Original Article

Comparison of Superior and Inferior Division Occlusions Treated with Endovascular Thrombectomy

verfasst von: Fatih Seker, Johannes Pfaff, Ulf Neuberger, Simon Schieber, Simon Nagel, Peter A. Ringleb, Martin Bendszus, Markus A. Möhlenbruch

Erschienen in: Clinical Neuroradiology | Ausgabe 2/2020

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Abstract

Background and Purpose

Several studies have shown that thrombectomy is safe and effective in occlusions of the M2 segment of the middle cerebral artery. This retrospective study compared superior and inferior division occlusions regarding radiological and clinical outcomes.

Methods

Between 2009 and 2017, patients treated with thrombectomy due to occlusion of the superior or inferior division were selected. Univariate and multivariate analyses were performed to identify predictors of outcome and compare superior and inferior division occlusions.

Results

A total of 140 patients with superior (n = 87) and inferior (n = 53) division occlusion were included. Of patients with inferior division occlusion 66.0% achieved good outcome compared to 48.3% in patients with superior division occlusion (P = 0.041). Time from groin puncture to reperfusion, recanalization success, complication rate, hemorrhage rate and follow-up infarct size were similar in both groups. Independent predictors of good outcome were baseline Alberta Stroke Program Early CT Score (ASPECTS) (odds ratio, OR 1.74, 95% confidence interval, CI 1.21–2.58, P = 0.004), time from groin puncture to reperfusion (OR 0.99, 95% CI 0.98–1.0, P = 0.019) and Thrombolysis In Cerebral Infarction (TICI) score 2b-3 (OR 4.51, 95% CI 1.31–18.74, P = 0.024). Superior division occlusion was an independent predictor of poor outcome (OR 2.41, 95% CI 1.05–5.80, P = 0.042). Dominance of the occluded vessel and side of occlusion were not predictive.

Conclusion

Patients with superior division occlusion appear to have a lower chance of achieving good outcome despite similar recanalization rates and complication rates compared to inferior division occlusions.

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Titel: Comparison of Superior and Inferior Division Occlusions Treated with Endovascular Thrombectomy
verfasst von: Fatih Seker
Johannes Pfaff
Ulf Neuberger
Simon Schieber
Simon Nagel
Peter A. Ringleb
Martin Bendszus
Markus A. Möhlenbruch
Publikationsdatum: 20.02.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Neuroradiology / Ausgabe 2/2020
Print ISSN: 1869-1439
Elektronische ISSN: 1869-1447
DOI: https://doi.org/10.1007/s00062-019-00767-3

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Comparison of Superior and Inferior Division Occlusions Treated with Endovascular Thrombectomy