Impact of the Recanalization Level and the First-Pass Effect on Functional Outcomes in Patients After M2 MCA Occlusion Thrombectomy
Abstract
:1. Introduction
Distal and Medium Vessel Occlusion
2. Methods
2.1. Study Design and Oversight
2.2. Participants
2.3. Interventional Procedures
- Local anesthesia.
- Monitored anesthetic care (conscious sedation administered by an anesthesiology team), which can be beneficial for the patient, especially because of more stable blood pressure levels, the possibility of continuously monitoring neurological status and a shorter time to recanalization. On the other hand, sedative agents may potentially compromise the patient’s airway. As these are emergency cases, there is a risk of aspiration. Also, the involuntary movement of the patient may prolong the procedure.
- General anesthesia [17].
2.4. Measures
2.5. Outcomes
2.6. Statistical Analysis
3. Results
3.1. Basic Epidemiological Parameters
3.2. Primary and Secondary Outcomes
3.3. Safety Outcomes
4. Discussion
5. Strengths and Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Parameter | First-Pass mTICI 2c–3 (n = 63) | Non-First-Pass mTICI 2c–3 (n = 74) | p Value |
---|---|---|---|
% | 46 | 54 | |
Males (%) | 29 (46) | 30 (40.5) | 0.764 |
Females (%) | 34 (54) | 34 (59.1) | |
Age (mean ± SD) | 70.6 ± 12.5 | 72.6 ± 11.1 | 0.467 |
Admission NIHSS (median) | 11.5 | 10.0 | |
Arterial hypertension (%) | 51 (81) | 65 (87.8) | 0.269 |
Atrial fibrillation (%)—including primo-manifestation | 32 (50.8) | 38 (51.4) | 0.567 |
Diabetes mellitus (%) | 13 (20.6) | 18 (24.3) | 0.772 |
Wake-up stroke (%) | 8 (12.7) | 13 (17.6) | 0.430 |
i.v. Thrombolysis (%) | 28 (44.4) | 24 (32.4) | 0.149 |
ASPECTS score (mean ± SD/median) | 9.4 ± 1.0/10 | 9.4 ± 1.0/10 | |
Collateral score (mean ± SD/median) | 2.2 ± 0.5/2 | 2.2 ± 0.6/2 | |
M2 dominant branch (%) | 26 (41.3) | 37 (50) | 0.307 |
Parameter | mTICI 2b or Less (n = 19) | mTICI 2c–3 (n = 118) | p Value |
---|---|---|---|
mRS 0–2 (%) | 8 (42.1) | 81 (68.6) | 0.024 |
mRS 0–1 (%) | 1 (5.3) | 57 (48.3) | <0.001 |
Mortality = mRS 6 (%) | 9 (47.4) | 19 (16.1) | 0.002 |
Any ICH (%) | 6 (31.6) | 36 (30.5) | 0.925 |
Symptomatic ICH (%) | 1 (5.3) | 4 (3.4) | 0.686 |
Parameter | First-Pass mTICI 2c–3 (n = 63) | Non-First-Pass mTICI 2c–3 (n = 74) | p Value |
---|---|---|---|
mRS 0–2 (%) | 39 (61.9) | 50 (67.6) | 0.489 |
mRS 0–1 (%) | 31 (49.2) | 27 (36.5) | 0.133 |
Mortality = mRS 6 (%) | 12 (19.1) | 16 (21.6) | 0.710 |
Any ICH (%) | 17 (27) | 25 (33.8) | 0.390 |
Symptomatic ICH (%) | 3 (4.8) | 2 (2.7) | 0.522 |
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Pataky, S.; Fedorko, J.; Pedowski, P.; Skorvanek, M.; Gdovinova, Z. Impact of the Recanalization Level and the First-Pass Effect on Functional Outcomes in Patients After M2 MCA Occlusion Thrombectomy. J. Clin. Med. 2025, 14, 2563. https://doi.org/10.3390/jcm14082563
Pataky S, Fedorko J, Pedowski P, Skorvanek M, Gdovinova Z. Impact of the Recanalization Level and the First-Pass Effect on Functional Outcomes in Patients After M2 MCA Occlusion Thrombectomy. Journal of Clinical Medicine. 2025; 14(8):2563. https://doi.org/10.3390/jcm14082563
Chicago/Turabian StylePataky, Stefan, Jakub Fedorko, Piotr Pedowski, Matej Skorvanek, and Zuzana Gdovinova. 2025. "Impact of the Recanalization Level and the First-Pass Effect on Functional Outcomes in Patients After M2 MCA Occlusion Thrombectomy" Journal of Clinical Medicine 14, no. 8: 2563. https://doi.org/10.3390/jcm14082563
APA StylePataky, S., Fedorko, J., Pedowski, P., Skorvanek, M., & Gdovinova, Z. (2025). Impact of the Recanalization Level and the First-Pass Effect on Functional Outcomes in Patients After M2 MCA Occlusion Thrombectomy. Journal of Clinical Medicine, 14(8), 2563. https://doi.org/10.3390/jcm14082563