Factors associated with favorable outcome of patients with acute internal carotid artery occlusion and patent middle cerebral artery treated by endovascular therapy

Abstract

Background and Purpose: We aimed to clarify factors associated with a favorable outcome of patients receiving endovascular therapy (EVT) for internal carotid artery occlusion and patent middle cerebral artery (ICOPM). Methods: Subjects were consecutive patients with ICOPM who received EVT in our hospital between May 2014 and July 2021. We examined their baseline characteristics and time index, treatment contents, and clinical outcomes. Furthermore, we classified them into two groups, those with favorable outcomes who showed mRS 0–2 at 3 months (G group) and those with poor outcomes who showed mRS 3–6 at 3 months (P group), and compared each factor. Results: Thirty-six patients were included among the 511 who received EVT. The median age was 85 years, 23 were male, and the median NIHSS score was 17.5. The onset-to-door time was 200 minutes, and the puncture to recanalization time (P2R) was 84.5 minutes. Embolization to the distal territory was noted in 9 cases, and complete reperfusion (mTICI 2b–3) was observed in 32 patients. There were 13 patients in the G group. Compared with the P group, P2R was significantly shorter in the G group. Conclusion: Patients with ICOPM who received EVT numbered 36 (7%), among whom complete reperfusion and favorable outcomes were observed in 32 and 13 patients, respectively. These results indicate that EVT for ICOPM does not lead to a poor outcome. Compared with the P group, the G group showed a shorter P2R, but ICOPM involves a complex pathology, so a short P2R does not directly lead to an improved outcome.