Volume 19 Issue 10
Oct.  2021
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Article Navigation >  Chinese Journal of General Practice  > 2021  >  19(10): 1633-1636,1649
ZHU Yu-you, WANG Li, LIU Tian-long, ZHANG Chao, SONG Jian-long, WANG Peng, SUN Wen, HU Wei, WANG Guo-ping. Therapeutic effect analysis of mechanical thrombectomy for acute middle cerebral artery M2 segment occlusion[J]. Chinese Journal of General Practice, 2021, 19(10): 1633-1636,1649. doi: 10.16766/j.cnki.issn.1674-4152.002129
Citation: ZHU Yu-you, WANG Li, LIU Tian-long, ZHANG Chao, SONG Jian-long, WANG Peng, SUN Wen, HU Wei, WANG Guo-ping. Therapeutic effect analysis of mechanical thrombectomy for acute middle cerebral artery M2 segment occlusion[J]. Chinese Journal of General Practice, 2021, 19(10): 1633-1636,1649. doi: 10.16766/j.cnki.issn.1674-4152.002129
shu

Therapeutic effect analysis of mechanical thrombectomy for acute middle cerebral artery M2 segment occlusion

doi: 10.16766/j.cnki.issn.1674-4152.002129
  • 1.

    Department of Neurology, the First Affiliated Hospital of USTC, Hefei, Anhui 230001, China

Funds:

 1804h08020250

 201904a07020086

  • Received Date: 2021-02-25
    Available Online: 2022-02-15
    Abstract
  •   Objective  To explore the efficacy and safety of mechanical thrombectomy for acute occlusion of the M2 segment of the middle cerebral artery.  Methods  Twenty patients with acute cerebral infarction who were subjected to mechanical thrombectomy for M2 segment middle cerebral artery occlusion in the First Affiliated Hospital of the University of Science and Technology of China from September 2019 to October 2020 were retrospectively collected. Amongst them, 8 were males, and 12 were females. Their ages ranged from 32 to 84 (62.5±14.4) years. The National Institutes of Health Stroke Scale score was (14±3) on admission. The preoperative ASPECTS score was 8.0 (7.0, 9.0) points. The aetiology classification adopted was TOAST classification, including 2 cases of aortic atherosclerosis, 10 cases of cardiogenic embolism, 5 cases of other causes, 3 cases of unknown cause. Before mechanical thrombectomy, intravenous thrombolysis was performed in 6 cases, of which 5 cases were treated with recombinant tissue plasminogen activator and 1 case with urokinase. There were 14 patients with dominant M2. The operation mode, recanalization and intracranial hemorrhage were analyzed, and the prognosis 90 days after operation was analyzed. An mTICI grade 2b-3 indicated successful recanalisation of blood vessels, and an mRS score of 0-2 meant good clinical prognosis.  Results  The average time from onset to femoral artery puncture in 20 patients was 200-582 min, the median time was 370 (277, 483) min, and the time from onset to recanalisation was (481.3±121.4) min. Stents were only used in 6 patients to remove the thrombus, direct aspiration was only used in 8 patients to remove the embolus, and stent combined with aspiration technology was used in 6 patients to remove the embolus. The number of emboli removed was 2 (1, 2). The successful recanalisation rate was 95%. Four patients had intracranial haemorrhage, and two of them had symptomatic intracranial haemorrhage. At 90-day follow-up, 1 patient died, the good prognosis rate was 65%. Univariate analysis showed that combined intravenous thrombolysis, without sICH were associated with good 90-day prognosis.  Conclusion  Mechanical thrombectomy for acute ischemic stroke patients with middle cerebral artery M2 occlusion is safe and effective. Combined intravenous thrombolysis, without sICH are associated with good prognosis at 90 days.

     

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