2016 Volume 11 Issue 1 Pages 18-23
Purpose: This study investigated the efficacy of endovascular therapy for occlusion of the second segment (M2) of the middle cerebral artery (MCA) in patients who were ineligible for intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA).
Materials and Methods: The subjects were 29 patients with M2 occlusion who were admitted between December 2010 and July 2015. In total, 21 patients were assigned to medical therapy and 8 received endovascular therapy.
Results: We compared background factors and the outcome between the two groups. We also assessed the impact of endovascular therapy on the outcome by multivariate analysis. After 90 days, the mean modified Rankin Scale (mRS) score was significantly lower in the endovascular therapy group than in the medical therapy group (1.62 ± 0.50 vs. 3.00 ± 0.31, P = 0.02). Multivariate analysis showed that the age (odds ratio [OR]: 0.83, 95% confidence interval [CI]: 0.61–0.99, P = 0.04), the National Institutes of Health Stroke Scale (NIHSS) score on admission (OR: 0.58, 95% CI: 0.27–0.83, P <0.01), and endovascular therapy (OR: 160, 95% CI: 1.28–985,014, P = 0.03) were independent predictors of an mRS score ≤2 after 90 days.
Conclusion: Endovascular therapy is effective for M2 occlusion in patients showing diffusion-weighted imaging/CT perfusion mismatch who are ineligible for intravenous thrombolysis.
