Scholarlink

Background <p>Non-acute middle cerebral artery occlusion (NAMCAO) is a significant cause of ischemic stroke, often resulting in persistent neurological deficits and a high risk of recurrence. Endovascular therapy (EVT) shows potential benefit but faces challenges related to microvascular reperfusion and procedural safety, particularly in the perforator territories supplied by Lenticulostriate arteries (LSAs).</p> Methods <p>A retrospective cohort of 112 consecutive patients with symptomatic NAMCAO treated by EVT at three centers was analyzed. Clinical assessments included NIHSS and modified Rankin Scale (mRS) scores at baseline and 6 months. Imaging evaluation included digital subtraction angiography to grade LSA reperfusion and CT perfusion parameters. Statistical analyses included logistic and ordinal regression analyses to identify predictors of outcomes and complications.</p> Results <p>The technical success rate of EVT was 91.1%, demonstrating an acceptable safety profile with a low periprocedural complication rate of 7.1%. Frequent reappearance of Lateral lenticulostriate arteries (LLSAs) was observed after middle cerebral artery (MCA) occlusion recanalization, indicating improved microvascular perfusion. Importantly, no significant differences in complication rates were observed across LLSA reappearance grades, underscoring the protective role of collateral compensation among perforating arteries. Significant neurological recovery was demonstrated by reductions in NIHSS and mRS scores from baseline to 6-month follow-up (<i>p</i> &lt; 0.001). Postprocedural perfusion status (mTICI) was significantly associated with successful reperfusion, further supporting the benefit of EVT in restoring cerebral perfusion.</p> Conclusion <p>Endovascular therapy in symptomatic NAMCAO is safe and effective, significantly improving microvascular reperfusion and neurological outcomes without increasing perforator-related complications. Careful patient selection and collateral status evaluation optimize procedural success. Prospective studies using advanced imaging biomarkers are needed to refine therapeutic strategies.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Endovascular therapy for symptomatic non-acute middle cerebral artery occlusion: impact on Lenticulostriate arteries reperfusion and clinical safety

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年3月26日

查看全文
  • Yujie Sun,
  • Penghui Ye,
  • Zunwei Wang,
  • Yong Zhang,
  • Yongkun Li

摘要

Background

Non-acute middle cerebral artery occlusion (NAMCAO) is a significant cause of ischemic stroke, often resulting in persistent neurological deficits and a high risk of recurrence. Endovascular therapy (EVT) shows potential benefit but faces challenges related to microvascular reperfusion and procedural safety, particularly in the perforator territories supplied by Lenticulostriate arteries (LSAs).

Methods

A retrospective cohort of 112 consecutive patients with symptomatic NAMCAO treated by EVT at three centers was analyzed. Clinical assessments included NIHSS and modified Rankin Scale (mRS) scores at baseline and 6 months. Imaging evaluation included digital subtraction angiography to grade LSA reperfusion and CT perfusion parameters. Statistical analyses included logistic and ordinal regression analyses to identify predictors of outcomes and complications.

Results

The technical success rate of EVT was 91.1%, demonstrating an acceptable safety profile with a low periprocedural complication rate of 7.1%. Frequent reappearance of Lateral lenticulostriate arteries (LLSAs) was observed after middle cerebral artery (MCA) occlusion recanalization, indicating improved microvascular perfusion. Importantly, no significant differences in complication rates were observed across LLSA reappearance grades, underscoring the protective role of collateral compensation among perforating arteries. Significant neurological recovery was demonstrated by reductions in NIHSS and mRS scores from baseline to 6-month follow-up (p < 0.001). Postprocedural perfusion status (mTICI) was significantly associated with successful reperfusion, further supporting the benefit of EVT in restoring cerebral perfusion.

Conclusion

Endovascular therapy in symptomatic NAMCAO is safe and effective, significantly improving microvascular reperfusion and neurological outcomes without increasing perforator-related complications. Careful patient selection and collateral status evaluation optimize procedural success. Prospective studies using advanced imaging biomarkers are needed to refine therapeutic strategies.