Background:
Endovascular thrombectomy (EVT) is the standard of care for treatment of stroke caused by large vessel occlusion; however recent trial data has not shown similar benefit for stroke caused medium vessel occlusion. We sought to examine the clinical characteristics and outcomes in a real-world observational cohort of EVT for medium vessel occlusion stroke
Methods:
Consecutive patients presenting for EVT after stroke caused by occlusion of either the M2 or M3 segment of the middle cerebral artery were included in this retrospective analysis. Collected data included admission national institute of health stroke scale (NIHSS) score, Alberta Stroke Programme Early CT score (ASPECTS), anaesthesia method and 3-month modified Rankin scale (mRS) score.
Results:
351 EVT patients (186 male, median [interquartile range] age of 72 [61-81]) were included. Median admission NIHSS score was 12 [interquartile range 8-16], median admission ASPECTS was 9 [interquartile range 8-10]. 182 (52%) patients received thrombolysis and 309 (88%) had EVT under general anaesthesia. At 90 days, 137 of 351 (39%) patients had a modified Rankin scale score of 0 or 1 and 39 of 351 (11%) patients died.
Conclusions:
Compared with recent trials on EVT in medium vessel occlusion stroke, this real-world observational cohort showed increased admission stroke severity, greater rates of general anaesthesia and similar 3-month outcomes.