Short-Vessel Occlusion Might Indicate Higher Possibility of Success in Reperfusion following Mechanical Thrombectomy in Acute Middle Cerebral Artery Occlusion

Background: The impact of the length of the occluded vessel in acute large-vessel occlusion on successful reperfusion by mechanical thrombectomy remains unclear. This study evaluated whether diameter and length of the occluded vessel in acute middle cerebral artery (MCA) occlusion might relate to su...

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Autores principales:	Tomoyuki Yoshihara, Ryuzaburo Kanazawa, Takanori Uchida, Tetsuhiro Higashida, Hidenori Ohbuchi, Naoyuki Arai, Yuichi Takahashi
Formato:	article
Lenguaje:	EN
Publicado:	Karger Publishers 2021
Materias:	flat-panel detector computed tomography maximum intensity projection middle cerebral artery reperfusion thrombectomy Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/a2e8834d11bd48ec9b2c0807e1ee66e1
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spelling	oai:doaj.org-article:a2e8834d11bd48ec9b2c0807e1ee66e12021-12-02T12:40:23ZShort-Vessel Occlusion Might Indicate Higher Possibility of Success in Reperfusion following Mechanical Thrombectomy in Acute Middle Cerebral Artery Occlusion1664-545610.1159/000519556https://doaj.org/article/a2e8834d11bd48ec9b2c0807e1ee66e12021-11-01T00:00:00Zhttps://www.karger.com/Article/FullText/519556https://doaj.org/toc/1664-5456Background: The impact of the length of the occluded vessel in acute large-vessel occlusion on successful reperfusion by mechanical thrombectomy remains unclear. This study evaluated whether diameter and length of the occluded vessel in acute middle cerebral artery (MCA) occlusion might relate to successful reperfusion following mechanical thrombectomy. Methods: This retrospective study included patients with acute MCA occlusion who underwent intra-aortic injection of contrast medium to obtain maximum intensity projection (MIP) images acquired by flat-panel detector computed tomography (FD-CT) equipped with an angiographic system. All patients received mechanical thrombectomy and were divided into two groups: those with successful reperfusion (Thrombolysis in Cerebral Infarction [TICI] 2b/3) and those without. We compared the diameter and length of the occluded vessel between the groups. In the sub-analysis of patients with stent retriever use, ratio of length of occluded vessel to length of the active zone was compared. Results: We enrolled 29 patients (median age: 73, M1 occlusion: 51%, stent retriever use: 72%). Eighteen patients achieved TICI 2b/3 with significantly larger distal end diameter (1.7 [interquartile range: 1.5–1.9] vs. 1.2 [1.2–1.5] mm, p = 0.007) and shorter length (7.1 [4.9–9.7] vs. 12.3 [7.2–15.8] mm, p = 0.043) of the occluded vessel. Sub-analysis of 21 patients showed that the cut-off value for TICI 2b/3 reperfusion was 0.32 as the ratio between the occluded vessel and stent retriever active zone (receiver operating characteristic area under the curve: 0.90). Conclusion: In acute MCA occlusion, larger diameter of the distal end and shorter length of the occluded vessel on FD-CT MIP images might indicate a higher possibility of achieving TICI 2b/3 following mechanical thrombectomy.Tomoyuki YoshiharaRyuzaburo KanazawaTakanori UchidaTetsuhiro HigashidaHidenori OhbuchiNaoyuki AraiYuichi TakahashiKarger Publishersarticleflat-panel detector computed tomographymaximum intensity projectionmiddle cerebral arteryreperfusionthrombectomyDiseases of the circulatory (Cardiovascular) systemRC666-701ENCerebrovascular Diseases Extra, Vol 11, Iss 3, Pp 131-136 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	flat-panel detector computed tomography maximum intensity projection middle cerebral artery reperfusion thrombectomy Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	flat-panel detector computed tomography maximum intensity projection middle cerebral artery reperfusion thrombectomy Diseases of the circulatory (Cardiovascular) system RC666-701 Tomoyuki Yoshihara Ryuzaburo Kanazawa Takanori Uchida Tetsuhiro Higashida Hidenori Ohbuchi Naoyuki Arai Yuichi Takahashi Short-Vessel Occlusion Might Indicate Higher Possibility of Success in Reperfusion following Mechanical Thrombectomy in Acute Middle Cerebral Artery Occlusion
description	Background: The impact of the length of the occluded vessel in acute large-vessel occlusion on successful reperfusion by mechanical thrombectomy remains unclear. This study evaluated whether diameter and length of the occluded vessel in acute middle cerebral artery (MCA) occlusion might relate to successful reperfusion following mechanical thrombectomy. Methods: This retrospective study included patients with acute MCA occlusion who underwent intra-aortic injection of contrast medium to obtain maximum intensity projection (MIP) images acquired by flat-panel detector computed tomography (FD-CT) equipped with an angiographic system. All patients received mechanical thrombectomy and were divided into two groups: those with successful reperfusion (Thrombolysis in Cerebral Infarction [TICI] 2b/3) and those without. We compared the diameter and length of the occluded vessel between the groups. In the sub-analysis of patients with stent retriever use, ratio of length of occluded vessel to length of the active zone was compared. Results: We enrolled 29 patients (median age: 73, M1 occlusion: 51%, stent retriever use: 72%). Eighteen patients achieved TICI 2b/3 with significantly larger distal end diameter (1.7 [interquartile range: 1.5–1.9] vs. 1.2 [1.2–1.5] mm, p = 0.007) and shorter length (7.1 [4.9–9.7] vs. 12.3 [7.2–15.8] mm, p = 0.043) of the occluded vessel. Sub-analysis of 21 patients showed that the cut-off value for TICI 2b/3 reperfusion was 0.32 as the ratio between the occluded vessel and stent retriever active zone (receiver operating characteristic area under the curve: 0.90). Conclusion: In acute MCA occlusion, larger diameter of the distal end and shorter length of the occluded vessel on FD-CT MIP images might indicate a higher possibility of achieving TICI 2b/3 following mechanical thrombectomy.
format	article
author	Tomoyuki Yoshihara Ryuzaburo Kanazawa Takanori Uchida Tetsuhiro Higashida Hidenori Ohbuchi Naoyuki Arai Yuichi Takahashi
author_facet	Tomoyuki Yoshihara Ryuzaburo Kanazawa Takanori Uchida Tetsuhiro Higashida Hidenori Ohbuchi Naoyuki Arai Yuichi Takahashi
author_sort	Tomoyuki Yoshihara
title	Short-Vessel Occlusion Might Indicate Higher Possibility of Success in Reperfusion following Mechanical Thrombectomy in Acute Middle Cerebral Artery Occlusion
title_short	Short-Vessel Occlusion Might Indicate Higher Possibility of Success in Reperfusion following Mechanical Thrombectomy in Acute Middle Cerebral Artery Occlusion
title_full	Short-Vessel Occlusion Might Indicate Higher Possibility of Success in Reperfusion following Mechanical Thrombectomy in Acute Middle Cerebral Artery Occlusion
title_fullStr	Short-Vessel Occlusion Might Indicate Higher Possibility of Success in Reperfusion following Mechanical Thrombectomy in Acute Middle Cerebral Artery Occlusion
title_full_unstemmed	Short-Vessel Occlusion Might Indicate Higher Possibility of Success in Reperfusion following Mechanical Thrombectomy in Acute Middle Cerebral Artery Occlusion
title_sort	short-vessel occlusion might indicate higher possibility of success in reperfusion following mechanical thrombectomy in acute middle cerebral artery occlusion
publisher	Karger Publishers
publishDate	2021
url	https://doaj.org/article/a2e8834d11bd48ec9b2c0807e1ee66e1
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Short-Vessel Occlusion Might Indicate Higher Possibility of Success in Reperfusion following Mechanical Thrombectomy in Acute Middle Cerebral Artery Occlusion

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