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Flowchart of patient selection.
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MCA Segment Anatomic Definition M1 Horizontal segment of the proximal MCA from the bifurcation of the ICA into the anterior and middle cerebral arteries to the genu of the MCA branch or branches at the entrance to the insula M2 Vertical MCA branches in the Sylvian fissure originating at the genu and extending to the next genu at the level of the operculum; if the anterior temporal artery arises from the horizontal M1 segment, it will not be considered an M2 branch M3 Branches that continue when the M2 branches change course again to a more lateral/horizontal course in the Sylvian fissure away from the insula and below the operculum M4 Branch vessels primarily extend vertically over the frontal and parietal lobes and inferiorly over the temporal lobe M2 Occlusion (n = 50) M1 Occlusion (n = 249) P Value Age (yr) (mean) 71 ± 11 67 ± 13 .04 Female 48% (24/50) 57% (143/249) .28 NIHSS score (median) (IQR) 13 (10–17) 17 (14–20) <.001 Medical history Atrial fibrillation 38% (19/50) 37% (93/249) 1.000 Hypertension 70% (35/50) 61% (152/249) .27 Diabetes 18% (9/50) 15% (38/249) .67 Hyperlipidemia 30% (15/50) 37% (93/249) .42 Peripheral artery disease 0% (0/50) 4% (9/249) .37 Current smoker 14% (7/49) 21% (53/249) .33 Prior stroke/TIA 12% (6/50) 17% (42/249) .53 Systolic BP (mean) (mm Hg) 150 ± 28 147 ± 23 .45 Diastolic BP (mean) (mm Hg) 84 ± 17 80 ± 15 .11 Left-sided occlusion 54% (27/50) 47% (117/249) .44 Baseline ASPECTS (mean) 9.0 ± 1.3 8.2 ± 1.7 .003 Receipt of IV tPA 77% (36/47) 69% (161/234) .38 Laboratory data Baseline serum glucose level (mean) 127 ± 51 128 ± 55 .89 INR (mean) 1.1 ± 0.5 1.1 ± 0.3 .95 Platelets (mean) 235 ± 75 234 ± 79 .95 aPTT (mean) (sec) 31 ± 20 29 ± 22 .44 Note:—IQR indicates interquartile range; BP, blood pressure; INR, international normalized ratio; aPTT, activated partial thromboplastin time.
↵a Categoric variables are given as percentages with n/N in parentheses, where n is the number of patients in whom the variable was present and N the total number of patients for whom that particular variable was reported.
M2 Occlusion (N = 50) M1 Occlusion (N = 249) P Value Time from groin puncture to recanalization (min) (median) (IQR) 29 (22–45) 35 (25–52) .41 No. of passes with stent retriever (mean) 1.4 ± 0.8 1.7 ± 1.0 .07 ≥3 Passes with stent retriever 13% (5/38) 23% (52/227) .21 mTICI 2b or 3 reperfusion 85% (34/40) 82% (193/235) .82 Rescue therapy 6% (3/50) 8% (19/249) 1.000 Complications Device-related serious adverse events 6% (3/50) 4% (10/249) .46 Symptomatic ICH 2% (1/50) 2% (5/249) 1.000 Outcome at 90-day follow-up mRS 0–1 50% (25/50) 41% (100/243) .27 mRS 0–2 60% (30/50) 56% (136/243) .64 Mortality 12% (6/50) 10% (25/249) .62 Note:—mTICI indicates modified Thrombolysis in Cerebral Infarction; ICH, intracerebral hemorrhage; IQR, interquartile range.
↵a Categoric variables are given as percentages with n/N in parentheses, where n is the number of patients in whom the variable was present, and N is the total number of patients for whom that particular variable was reported.
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