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ORIGINAL RESEARCH article
Front. Neurol.
Sec. Endovascular and Interventional Neurology
Volume 15 - 2024 |
doi: 10.3389/fneur.2024.1424030
This article is part of the Research Topic Distal, Medium Vessel Occlusion Stroke: Epidemiology, Diagnostics, Treatment Options, and Outcome Prediction View all articles
Combining the Deployment of Only the Distal Basket Segment of the EMBOTRAP III and an Aspiration Catheter for M2 Occlusions: The ONE-SEG Technique
Provisionally accepted- 1 Kagoshima Medical Center (NHO), Kagoshima, Japan
- 2 St. Luke's International Hospital, Tokyo, Japan
- 3 Department of Neurology and Geriatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan
Background: Endovascular therapy (EVT) for distal medium vessel occlusions requires prioritizing effectiveness and safety. We developed a technique combining the deployment of only the distal basket segment of the EMBOTRAP III and an aspiration catheter (AC) for M2 occlusions, called the “ONE-SEG technique,” and evaluated its clinical and technical impacts. Methods: This was a retrospective review of 30 consecutive patients with M2 segment middle cerebral artery occlusion treated using the ONE-SEG technique. This method involves deploying the EMBOTRAP III through a microcatheter in only one segment and guiding the AC to the M2 origin or distal M1. The rates of final-pass expanded thrombolysis in cerebral infarction (eTICI) scores of 2c/3 or 2b/2c/3, safety (symptomatic intracranial haemorrhage [sICH]), and clinical outcomes (modified Rankin Scale [mRS] score 0-2, 0-3 at 90 days, and mortality at 90 days) were evaluated. Results: Of the 30 cases, 36.7% were female, and the mean age was 75.6±11.0 years. The ONE-SEG technique was used for 17 cases (56.7%, median NIHSS 10 [5–15.5]) with primary M2 occlusion and 13 cases (43.3%, median NIHSS 20 [14–22.5]) with secondary M2 occlusion after proximal thrombus removal. The successful final reperfusion rate (eTICI 2b/2c/3) was 90% overall (27/30 cases). One case (3.3%) developed sICH with secondary M2 occlusion. At 3 months, mRS scores 0-2 were seen in 64.7% of patients with primary M2 occlusion (11/17 cases) and in 23.1% (3/13 cases) with secondary M2 occlusion. Conclusions: EVT using the ONE-SEG technique appears to be safe and effective for M2 occlusion.
Keywords: Thrombectomy, Stroke, M2 occlusion, intervention, MeVO, DMVOs
Received: 08 May 2024; Accepted: 14 Aug 2024.
Copyright: © 2024 Hamada, Matsuoka, Sato, Kawabata, Iwamoto, Ikeda, Sato, Takaguchi and Takashima. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yuki Hamada, Kagoshima Medical Center (NHO), Kagoshima, Japan
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Hideki Matsuoka
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