ArticleClinical neuroradiology2025
Outcomes After Thrombectomy for Primary and Secondary Medium Vessel MCA Occlusions: a Nationwide Registry Study.
Article in Clinical neuroradiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.
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Who cites it
4 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Effects of thrombus migration on endovascular treatment outcomes in patients with ischemic stroke: a systematic review and meta-analysis.Journal of neurology · 2026Pooled it
- Evidence, strategies, and pathways for thrombectomy in medium vessel occlusion stroke: a systematic review.Frontiers in neurology · 2026Pooled it
- Reframing Medium-Vessel Occlusion Thrombectomy in Acute Ischemic Stroke: Device-Vessel Matching and Patient Selection as Keys to Clinical Benefit.Clinical neuroradiology · 2026Article
- Distal Vessel Occlusion Stroke: Lessons from Recent Randomized Trials and Implications for Future Study Design.Annals of Indian Academy of Neurology · 2026Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMedium vessel occlusions (MeVO) can be either isolated events (primary), or secondary to thrombus migration from a large vessel occlusion to a medium-sized vessel. Outcomes following endovascular thrombectomy (EVT) in the middle cerebral artery (MCA) may differ between primary and secondary MeVOs. This study aimed to assess the association between primary/secondary MeVOs and clinical outcomes following EVT in a nationwide patient cohort.
methodPatients undergoing EVT were included in two Swedish quality registries. Secondary MeVO was defined as distal migration of a solitary thrombus between baseline CT-angiography and EVT, or basal ganglia infarction on postoperative CT in a patient that presented with a single MeVO on baseline CT-angiography. The primary outcome was good 90-day functional outcome (modified Rankin Scale 0-2). Postoperative change in the National Institutes of Health Stroke Scale-score (NIHSS), was a secondary outcome. Successfully revascularized patients (mTICI 2b-3) were compared with non-revascularized patients in exploratory analyzes.
resultsOf the 5662 EVTs performed in Sweden (2018-2022), 1118 (20%) targeted solitary MCA territory MeVOs, with 819 (73%) being primary and 299 (27%) secondary. Functional outcomes did not differ between the primary and secondary MeVO groups (OR 0.86, CI 95% 0.65-1.14). Likewise, there was no significant difference in postoperative NIHSS scores (0.26, CI 95% -0.71 to 1.24), between groups (p = 0.597). Successful revascularization was associated with increased chance of good functional outcome for both primary (OR 3.77, CI95% 2.28-6.24, p < 0.001) and secondary MeVOs (OR 2.49, CI95% 1.21-5.14, p = 0.013).
conclusionsPatients with a single primary or secondary MCA MeVOs have similar EVT outcomes and both groups seem to benefit from recanalization in exploratory analyses. This indicates that that EVT should not be withheld based on primary/secondary MeVO status.
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