title: Is intra-arterial thrombolysis beneficial for M2 occlusions? Subgroup analysis of the PROACT-II trial.
abstract: OBJECTIVE
  The role of endovascular therapy for acute M2 trunk occlusions is debatable. Through a subgroup analysis of Prolyse in Acute Cerebral Thromboembolism-II, we compared outcomes of M2 occlusions in treatment and control arms.
  
  
  METHODS
  Solitary M2 occlusions were identified from the Prolyse in Acute Cerebral Thromboembolism-II database. Primary endpoints were successful angiographic reperfusion (TICI 2-3) at 120 minutes and functional independence (mRS 0-2) at 90 days.
  
  
  RESULTS
  Forty-four patients with solitary M2 occlusions, 30 in the treatment arm and 14 in the control arm, were identified. Successful reperfusion (TICI 2-3) was achieved in 53.6% and 16.7% of patients in the treatment and control arms, respectively (P=0.04). A favorable clinical outcome (mRS 0-2) was observed in 53.3% and 28.6%, respectively (P=0.19). Baseline characteristics were similar between the 2 groups.
  
  
  CONCLUSIONS
  Intra-arterial thrombolysis may lead to a 3-fold increase in the rate of early reperfusion of solitary M2 occlusions and could potentially double the chance of a favorable functional outcome at 90 days.  Clinical Trial Registration- This trial was not registered because enrollment began before July 1, 2005.
authors.affiliation: Department of Neurosurgery, University of Cincinnati, Cincinnati, OH 45219, USA. rrahme@waln.org
authors.forename: Ralph
authors.initials: R
authors.lastname: Rahme
authors.forename: Todd A
authors.initials: TA
authors.lastname: Abruzzo
authors.forename: Renee' Hebert
authors.initials: RH
authors.lastname: Martin
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Tomsick
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Ringer
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Furlan
authors.forename: Janice A
authors.initials: JA
authors.lastname: Carrozzella
authors.forename: Pooja
authors.initials: P
authors.lastname: Khatri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000453:epidemiology*; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011994:Recombinant Proteins / Q000008:administration & dosage; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage*
chemical_list: D011994:Recombinant Proteins; D014568:Urokinase-Type Plasminogen Activator; C067551:saruplase