Mechanical Thrombectomy Comparable to Best Medical Treatment for Rare Type of Stroke

Similar favorable functional outcomes seen for both thrombectomy and medical management in patients with distal medium vessel occlusion of anterior cerebral artery

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TUESDAY, March 7, 2023 (HealthDay News) -- For patients with primary isolated distal medium vessel occlusions (DMVOs) of the anterior cerebral artery (ACA), mechanical thrombectomy (MT) has comparable clinical and safety outcomes to best medical treatment (BMT), according to a study published online Feb. 14 in Radiology.

Lukas Meyer, M.D., from University Medical Center Hamburg-Eppendorf in Germany, and colleagues compared the clinical and safety outcomes between MT and BMT with or without intravenous thrombolysis for patients with primary isolated ACA DMVOs. Data were included for 154 patients, of whom 110 treated with thrombectomy or BMT alone were propensity score matched (55 in each group).

The DMVOs were in A2, A3, and A4 in 53, 45, and 2 percent of patients, respectively. The researchers found that the median 24-hour National Institutes of Health Stroke Scale score was −2 and −1 in the MT and BMT groups, respectively, after propensity score matching. Both groups had similar favorable functional outcomes (49 percent for both MT and BMT) and mortality (22 versus 31 percent for MT versus BMT). Three of the patients (2 percent) had symptomatic intracranial hemorrhage.

"Based on our study, both treatment options appear to be effective and safe," Meyer said in a statement. "The overall results of the study are consistent with a growing body of literature suggesting that thrombectomy may have a role in the treatment of this type of stroke. Eligible patients should therefore be randomized to ongoing prospective trials whenever possible."

Several authors disclosed financial ties to the pharmaceutical and medical device industries.

Abstract/Full Text

Elana Gotkine

Elana Gotkine

Medically reviewed by Mark Arredondo, M.D.

Published on March 07, 2023

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