title: Carotid Elongation Does Not Affect Angiographic Results of Mechanical Thrombectomy in Acute Stroke.
abstract: OBJECTIVE
  New techniques have substantially raised recanalization rates of mechanical thrombectomy in acute ischemic stroke in the last few years with initial prospective trials reporting good neurological outcome in up to 58 % of the cases. However some recent reports questioning the benefit of endovascular therapy have initiated a discussion about the importance of patient-selection. The purpose of this study was to investigate whether an elongation of the carotid artery affects the angiographic outcome of the recanalization procedure in middle cerebral artery (MCA)-occlusions.
  
  
  METHODS
  The data of 54 patients with occlusions of the M1-segment who underwent mechanical thrombectomy were included. The lengths of the carotid arteries were measured using preinterventional computed tomography (CT)-angiograms. To take individual patient's height into account these lengths were divided by the length of the spine from the tip of the dens to the bottom of the th3 vertebral body (referred to as carotid-to-spine (CS)-Ratio). Angiographic results were scored according to the modified thrombolysis in cerebral infarction (mTICI)-score.
  
  
  RESULTS
  Recanalization with mTICI ≥ 2b was achieved in 83.3 %. The mean CS-Ratio was 1.32 ± 0.13. There was a significant correlation between the CS-Ratio and the age of the patients. There were no significant differences in the CS-Ratios of occlusions that were successfully recanalized and those that were not. Neither were there significant correlations of the CS-Ratio and the length of procedure or the number of deployments of the stentretrievers.
  
  
  CONCLUSIONS
  In this retrospective analysis we report that carotid elongation does not affect angiographic results of mechanical thrombectomy in acute stroke.
authors.affiliation: Department of Neuroradiology, Saarland University Hospital, Kirrberger Str., 66424, Homburg, Germany. umut.yilmaz@uks.eu.
authors.forename: Umut
authors.initials: U
authors.lastname: Yilmaz
authors.affiliation: Department of Neuroradiology, Saarland University Hospital, Kirrberger Str., 66424, Homburg, Germany.
authors.forename: Ruben
authors.initials: R
authors.lastname: Mühl-Benninghaus
authors.affiliation: Department of Neuroradiology, Saarland University Hospital, Kirrberger Str., 66424, Homburg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Simgen
authors.affiliation: Department of Neuroradiology, Saarland University Hospital, Kirrberger Str., 66424, Homburg, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Reith
authors.affiliation: Department of Neuroradiology, Saarland University Hospital, Kirrberger Str., 66424, Homburg, Germany.
authors.forename: Heiko
authors.initials: H
authors.lastname: Körner
mesh_terms: D000368:Aged; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000473:pathology*; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D061185:Mechanical Thrombolysis; D009929:Organ Size; D018579:Patient Selection; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Carotid elongation; Mechanical thrombectomy; Stroke