ORIGINAL RESEARCH article
Front. Neurol.
Sec. Endovascular and Interventional Neurology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1650169
Predictive Factors of Successful Endovascular Recanalization for Symptomatic Atherosclerotic Non-Acute Middle Cerebral Artery Occlusion
Provisionally accepted
- 1The Seventh Affiliated Hospital Sun Yat-sen University, Shenzhen, China
- 2Tongji Hospital Affiliated to Tongji University, Shanghai, China
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Background: Endovascular recanalization treatment (EVRT) has emerged as a critical treatment modality for patients with symptomatic atherosclerotic non-acute middle cerebral artery occlusion (SNMCAO). However, several technical challenges persist, and the predictive factors for successful recanalization of SNMCAO are not yet fully understood. This study aimed to identify clinical and radiological factors associated with successful EVRT in patients with SNMCAO.We conducted a retrospective analysis on all patients with SNMCAO who underwent EVRT at two centers from January 2016 to December 2024. Demographic data, medical history, imaging characteristics, periprocedural complications, and 3-month follow-up results were collected. Logistic binary regression analysis was performed to assess the factors influencing the success of EVRT.Results: A total of 65 patients were included, with 50 achieving successful recanalization. The perioperative complication rate was 13.8% (9/65). Multivariate logistic binary regression analysis indicated that an occlusion duration of ≤3 months (P = 0.020), an occlusion segment length of ≤10 mm (P = 0.004), the presence of a distal vascular main trunk visualization (DVMTV) sign (P = 0.035), and the presence of a slow distal antegrade flow (SDFA) sign (P = 0.039) were identified as independent positive predictors of successful EVRT for SNMCAO.Occlusion duration of ≤3 months, occlusion length of ≤10 mm, the presence of a DVMTV sign and a SDFA sign were considered independent predictive factors for the success of EVRT in patients with SNMCAO.In particular, the DVMTV sign and SDFA sign were first proposed as predictors for EVRT of SNMCAO. These findings may be beneficial in predicting the likelihood of successful recanalization for SNMCAO and offer guidance for selecting appropriate candidates.
Keywords: Endovascular recanalization, Middle Cerebral Artery, Atherosclerosis, Non-acute occlusion, predictors
Received: 19 Jun 2025; Accepted: 21 Aug 2025.
Copyright: © 2025 Ma, Zhang, Yan, Bai, Zhang, Wu, Du, Lu and Tan. 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: Huaqiao Tan, The Seventh Affiliated Hospital Sun Yat-sen University, Shenzhen, China
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