ABSTRACT
Background and Purpose
Mechanical thrombectomy (MT) is increasingly performed for distal medium vessel occlusions (DMVOs) of the anterior circulation in acute stroke patients. Although trials have not shown superiority over usual care, selected patients may still benefit from MT. The ideal endovascular technique is debated. We aimed to determine the safety and efficacy of double stent retriever MT (DSR-MT) for DMVOs.
Methods
We retrospective analyzed demographics, procedure characteristics, and clinical data from consecutive patients with acute primary DMVOs treated with DSR-MT at four comprehensive stroke centers. Reperfusion was defined by the extended Thrombolysis In Cerebral Infarction (eTICI) score. Clinical outcomes were measured by the National Institute of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS) scores.
Results
We included 32 patients (median age, 78 years, interquartile range [IQR] 71–82; 16 [50%] female), of whom 26 (81.2%) had primary occlusion of the M2 segment of the middle cerebral artery and six (18.8%) had occlusion of M3. Clinical severity was moderate (median, NIHSS 13; IQR 10–15) in 24 patients (75%). First-pass effect (eTICI 2c/3) was achieved in 20 patients (62.5%). Final eTICI 2b/2c/3 was achieved in 30 patients (93.7%) and final eTICI 2c/3 in 25 (78.1%). Symptomatic intracranial hemorrhage developed in one patient (3.1%). Median NIHSS was 6 at 24 h (IQR 3–12) and 4 at discharge (IQR 1–9). At 90 days, 22 (73.3%) patients were functionally independent (mRS 0–2).
Conclusions
This preliminary study found good efficacy and safety of DSR-MT for DMVOs in patients with M2 and M3 occlusions.
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This post is Copyright: José Carlos Méndez,
Pedro Vega,
Alfonso Lopez‐Frías,
Teresa Díaz,
Josep Puig,
Eduardo Murias,
Jordi Blasco,
Carlos Pérez‐García,
Víctor Maestro,
Manuel Moreu,
Marc Comas‐Cufí,
Antonio Cruz‐Culebras,
María Antonia Prieto,
Isabel Bermúdez‐Coronel,
Javier Blázquez,
Jaime Masjuán | July 21, 2025
Wiley: Journal of Neuroimaging: Table of Contents