Thrombectomy for Cerebral Medium-Vessel Occlusion

Two randomized trials failed to show a benefit and indicated an increased risk for brain hemorrhage with mechanical thrombectomy in patients with acute ischemic stroke and medium-vessel occlusion.

Mechanical thrombectomy (MT) has been shown to improve outcomes for select patients with acute ischemic stroke due to large-vessel occlusion. Whether it is also safe and effective for patients with occlusions in branches (“medium vessels”) of the large cerebral vessels, such as the middle cerebral artery (MCA), is unknown. Two randomized trials now provide data on this topic.

In the first trial (DISTAL), 543 patients with acute ischemic stroke and medium-vessel occlusion (median age, 77 years; 44% women) were assigned to medical management with or without MT. Patients were enrolled within 24 hours of stroke onset, and the median NIH Stroke Scale (NIHSS) score was 6. Roughly two thirds of patients had occlusion of the main MCA branches, and t…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Thrombectomy for Cerebral Medium-Vessel Occlusion

Topics

Reviewing Author