title: Distance to Thrombus in acute middle cerebral artery stroke predicts basal ganglia infarction after mechanical thrombectomy.
abstract: OBJECTIVE
  This study examines if involvement of the lenticulostriate arteries (LSAs) in MCA stroke and consecutive infarction of the basal ganglia can be predicted by the exact occlusion site, as determined in pre-interventional CT or MRI imaging.
  
  
  METHODS
  Retrospective analysis of 212 patients with acute isolated MCA occlusions treated with mechanical thrombectomy. The occlusion site was assessed using the Distance to Thrombus (DT). Affection of LSAs by the occlusion was determined by analysis of pre- and post-interventional DSA runs. Infarction of the striatocapsular region was evaluated in post-interventional imaging.
  
  
  RESULTS
  DT showed a highly significant correlation with the affected LSA group (ρ = 0.747; P < 0.001). In a ROC analysis, DT could predict affection of the LSAs with an area under the curve (AUC) of 0.903. Additionally, DT could predict an infarction of the striatocapsular region with an AUC of 0.824. In a stepwise regression analysis for striatocapsular infarction including DT, age, time from symptom onset to recanalization and recanalization success, only DT proved to be an independent predictor.
  
  
  CONCLUSIONS
  In MCA stroke, the exact site of the occlusion as measured by DT independently predicts the involvement of LSAs and subsequent striatocapsular infarction with high sensitivity and specificity.
authors.affiliation: Department of diagnostic and interventional Neuroradiology, Klinikum rechts der Isar, Munich, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Friedrich
authors.affiliation: Department of Neuroradiology, University Hospital Leipzig, Leipzig, Germany.
authors.forename: Donald
authors.initials: D
authors.lastname: Lobsien
authors.affiliation: Department of diagnostic and interventional Neuroradiology, Klinikum rechts der Isar, Munich, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Maegerlein
authors.affiliation: Department of Neurology, Klinikum rechts der Isar, Munich, Germany.
authors.forename: Silke
authors.initials: S
authors.lastname: Wunderlich
authors.affiliation: Department of diagnostic and interventional Neuroradiology, Klinikum rechts der Isar, Munich, Germany.
authors.forename: Claus
authors.initials: C
authors.lastname: Zimmer
authors.affiliation: Department of diagnostic and interventional Neuroradiology, Klinikum rechts der Isar, Munich, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Kaesmacher
authors.affiliation: Department of diagnostic and interventional Neuroradiology, Klinikum rechts der Isar, Munich, Germany.
authors.forename: Justus
authors.initials: J
authors.lastname: Kleine
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020144:Basal Ganglia Cerebrovascular Disease / Q000209:etiology*; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000000981:diagnostic imaging / Q000601:surgery*; D017131:Thrombectomy / Q000379:methods*; D014057:Tomography, X-Ray Computed
keywords: basal ganglia; distance to thrombus; mechanical thrombectomy; stroke