E.2 Predictors of successful endovascular thrombectomy for M2 occlusion in acute ischemic stroke

Abstract

Background: There remains lack of data in regards to factors influencing successful endovascular reperfusion of isolated occlusion of the M2 segment of the middle cerebral artery (MCA). In this study, we set out to investigate the variables that affect the successful endovascular reperfusion of isolated M2 segment occlusion. Methods: M2 segment occlusion was defined as isolated clot anywhere within the M2 segment of the MCA. A prediction model of successful endovascular reperfusion defined as modified Thrombolysis in Cerebral Ischemia (mTICI) score of 2b, 2c and 3 and unsuccessful endovascular reperfusion defined as mTICI score of 0, 1 and 2a was developed from demographics (age, sex) , clinical factors (NIHSS at the time of presentation to hospital), imaging characteristics (ASPECTS, ICA occlusion, presence of Intracranial arterial disease (ICAD), computed tomography perfusion (CTP)-based ischemic core and mismatch volume estimation), and treatment (alteplase/tenecteplase use and periprocedural complications) variables from 64 patients who underwent endovascular thrombectomy (EVT) at Kingston Health Science Centre between December 24, 2018 and October 18, 2022. Results: The only statistical significant predictor of successful endovascular reperfusion was CTP-based ischemic core volume (smaller core volume) (p<0.05). Conclusions: The CTP-based ischemic core volume is the most important predictor of successful endovascular reperfusion for M2 occlusion.