title: Stent Retriever Thrombectomy in Different Thrombus Locations of Anterior Cerebral Circulation.
abstract: BACKGROUND
  Mechanical thrombectomy (MT) is a safe and efficient treatment for acute ischemic stroke in patients with proximal anterior occlusion and large penumbra. We evaluated the technical and clinical success of MT in relation to the location of the occlusion (internal carotid artery, M1 and M2 segments of the middle cerebral artery).
  
  
  METHODS
  We prospectively reviewed 130 patients of whom 105 met the inclusion criteria. Baseline clinical, procedural and imaging variables, technical outcome (TICI, thrombolysis in cerebral infarction), 24 h imaging outcome and three-month clinical outcome (mRS, modified Rankin Scale) were recorded. Differences between the groups were studied with statistical tests according to the type of the variable.
  
  
  RESULTS
  There were 37, 46 and 22 patients in the internal carotid artery (ICA), M1 and M2 groups, respectively. TICI 2b or 3 was achieved in 92 cases (88 %) with a non-significant trend towards a better recanalization outcome in the ICA and M1 groups. Overall, 57 of the 105 patients (55 %) experienced favorable clinical outcome (mRS ≤ 2) with no significant differences between the groups. Excellent outcome (mRS ≤ 1) was seen in 40 patients (39 %) and there proportionally more patients with excellent outcome in the ICA and M1 groups (ICA: 44 %, M1: 41 %, M2: 23 % of patients, p = 0.22).
  
  
  CONCLUSIONS
  There were no statistically significant differences in the technical or clinical outcomes between the different sites of occlusion (ICA, M1 or M2). There was a non-significant trend towards achieving excellent clinical outcome (3-month mRS ≤ 1) more often and better recanalization results in the two more proximal locations.
authors.affiliation: Medical Imaging Center, Tampere University Hospital, PL 2000, 33521, Tampere, Finland.
authors.forename: Sara
authors.initials: S
authors.lastname: Protto
authors.affiliation: Medical Imaging Center, Tampere University Hospital, PL 2000, 33521, Tampere, Finland. niko.sillanpaa@pshp.fi.
authors.forename: Niko
authors.initials: N
authors.lastname: Sillanpää
authors.affiliation: Medical Imaging Center, Tampere University Hospital, PL 2000, 33521, Tampere, Finland.
authors.forename: Juha-Pekka
authors.initials: JP
authors.lastname: Pienimäki
authors.affiliation: Medical Imaging Center, Tampere University Hospital, PL 2000, 33521, Tampere, Finland.
authors.forename: Ira
authors.initials: I
authors.lastname: Matkaselkä
authors.affiliation: Medical Imaging Center, Tampere University Hospital, PL 2000, 33521, Tampere, Finland.
authors.forename: Janne
authors.initials: J
authors.lastname: Seppänen
authors.affiliation: Department of Neurology, Tampere University Hospital, Tampere, Finland.
authors.forename: Heikki
authors.initials: H
authors.lastname: Numminen
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods; D000818:Animals; D002560:Cerebrovascular Circulation; D004285:Dogs; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D011446:Prospective Studies; D015641:Radiography, Interventional / Q000379:methods; D015607:Stents; D017131:Thrombectomy / Q000379:methods*; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
keywords: Interventional radiology; Ischemic stroke; Mechanical thrombectomy; Stent retriever