title: Manual Aspiration Thrombectomy Using Penumbra Catheter in Patients with Acute M2 Occlusion : A Single-Center Analysis.
abstract: OBJECTIVE
  The efficacy and safety of manual aspiration thrombectomy using Penumbra in an acute occlusion of large intracranial arteries has been proven in many previous studies. Our study aimed to retrospectively assess the efficacy and safety of manual aspiration thrombectomy using Penumbra in patients with small vessel occlusions (M2 segment of the MCA).
  
  
  METHODS
  We conducted a retrospective review of 32 patients who underwent manual aspiration thrombectomy using the Penumbra 4 MAX Reperfusion Catheter for treatment of an M2 occlusion between January 2013 and November 2014. We evaluated immediate angiographic results and clinical outcomes through review of patient electronic medical records.
  
  
  RESULTS
  There were slightly more men in this study (M : F=18 : 14) and the median age was 72.5 (age range : 41-90). The rate of successful recanalization (TICI grade ≥2b) was 84% (27/32). NIHSS at discharge and favorable clinical outcomes at 3 months were significantly improved than baseline. Median initial NIHSS score was 10 (range : 4-25) and was 4 (range : 0-14) at discharge. Favorable clinical outcomes (mRS score ≤2 at 3 months) were seen in 25 out of 32 patients (78%). There were no procedure-related symptomatic intracerebral hemorrhages. One patient expired after discharge due to a cardiac problem.
  
  
  CONCLUSIONS
  Manual aspiration thrombectomy might be safe and is capable of achieving a high rate of successful recanalization and favorable clinical outcomes in patients with distal cerebral vessel occlusion (M2).
authors.affiliation: Department of Neurosurgery, and Research Institute of Clinical Medicine of Chonbuk National University, Jeonju, Korea.; Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.
authors.forename: Jung Soo
authors.initials: JS
authors.lastname: Park
authors.affiliation: Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.; Department of Radiology, and Research Institute of Clinical Medicine of Chonbuk National University, Jeonju, Korea.
authors.forename: Hyo Sung
authors.initials: HS
authors.lastname: Kwak
keywords: Middle cerebral artery; Stroke; Thrombectomy