PMID- 38310761 OWN - NLM STAT- MEDLINE DCOM- 20240304 LR - 20240304 IS - 1872-6968 (Electronic) IS - 0303-8467 (Linking) VI - 237 DP - 2024 Feb TI - Thrombus migration in emergent M1 middle cerebral artery occlusion. PG - 108132 LID - S0303-8467(24)00019-2 [pii] LID - 10.1016/j.clineuro.2024.108132 [doi] AB - BACKGROUND AND PURPOSE: Thrombus migration (TM) is a well-established phenomenon in patients with intracranial vessel occlusion, particularly in those who receive alteplase. However, the relationship between TM, reperfusion success, and clinic-radiological outcomes is still being determined. This study aimed to describe the various outcomes in the event of TM in patients with M1 middle cerebral artery (M1 MCA) occlusion. MATERIALS AND METHODS: The study involved a retrospective analysis of patients undergoing endovascular thrombectomy (EVT) due to M1 MCA occlusion from two tertiary centers between January 2015 and December 2020. The proximal positions of thrombi were measured using a curve tool on CT or MR angiography before EVT. Subsequently, measurements were taken on angiographic imaging. Patients were grouped based on the amount of difference between the two measurements: growth ( -10 mm and 10 mm), and resolution. RESULTS: A total of 463 patients (266 [57%] females, median 76 [interquartile range IQR: 65-83] years) were analyzed. Of them, 106 (22.8%) expressed any degree of TM. In multivariate ordinal regression analysis, the alteplase was significantly associated with TM (t = 2.192, p = 0.028), as was the greater interval from first imaging to angiography (t = 2.574, p = 0.010). In multivariate logistical regression analysis, the good clinical outcome measured by the modified Rankin scale (0-2) was not associated with TM status. CONCLUSIONS: Thrombus migration within the M1 MCA segment occurs in almost a quarter of patients, is associated with alteplase administration, and is mainly irrelevant to radiological and clinical outcome. CI - Copyright (c) 2024 Elsevier B.V. All rights reserved. FAU - Pikija, Slaven AU - Pikija S AD - Department of Neurology, University Hospital Salzburg, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria. Electronic address: s.pikija@salk.at. FAU - Killer-Oberpfalzer, Monika AU - Killer-Oberpfalzer M AD - Department of Neurology, University Hospital Salzburg, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria. FAU - Pfaff, Johannes A R AU - Pfaff JAR AD - Department of Neuroradiology, University Hospital Salzburg, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria. FAU - Griessenauer, Christoph J AU - Griessenauer CJ AD - Department of Neurosurgery, University Hospital Salzburg, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria. FAU - Sonnberger, Michael AU - Sonnberger M AD - Department of Neuroradiology, Neuromed Campus, Johannes Kepler University, Linz, Austria. FAU - Vosko, Milan AU - Vosko M AD - Department of Neurology, Neuromed Campus, Johannes Kepler University, Linz, Austria. FAU - Mutzenbach, Johannes S AU - Mutzenbach JS AD - Department of Neurology, University Hospital Salzburg, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria. FAU - Schwarzenhofer, Daniel AU - Schwarzenhofer D AD - Department of Neurology, Neuromed Campus, Johannes Kepler University, Linz, Austria. FAU - Constantin, Hecker AU - Constantin H AD - Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria; Department of Neurosurgery, University Hospital Salzburg, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria. LA - eng PT - Journal Article DEP - 20240124 PL - Netherlands TA - Clin Neurol Neurosurg JT - Clinical neurology and neurosurgery JID - 7502039 RN - EC 3.4.21.68 (Tissue Plasminogen Activator) SB - IM MH - Female MH - Humans MH - Male MH - Infarction, Middle Cerebral Artery/diagnostic imaging/surgery MH - Retrospective Studies MH - Tissue Plasminogen Activator/therapeutic use MH - Magnetic Resonance Angiography MH - *Vascular Diseases MH - *Thrombosis OTO - NOTNLM OT - Endovascular thrombectomy OT - Ischemic stroke OT - Migration OT - Thrombolysis OT - Thrombus EDAT- 2024/02/05 00:42 MHDA- 2024/03/04 06:46 CRDT- 2024/02/04 18:07 PHST- 2023/08/27 00:00 [received] PHST- 2023/12/17 00:00 [revised] PHST- 2024/01/22 00:00 [accepted] PHST- 2024/03/04 06:46 [medline] PHST- 2024/02/05 00:42 [pubmed] PHST- 2024/02/04 18:07 [entrez] AID - S0303-8467(24)00019-2 [pii] AID - 10.1016/j.clineuro.2024.108132 [doi] PST - ppublish SO - Clin Neurol Neurosurg. 2024 Feb;237:108132. doi: 10.1016/j.clineuro.2024.108132. Epub 2024 Jan 24.