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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\u00a0nationwide patient cohort.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Method<\/jats:title>\n            <jats:p>Patients undergoing EVT were included in two Swedish quality registries. Secondary MeVO was defined as distal migration of a\u00a0solitary thrombus between baseline CT-angiography and EVT, or basal ganglia infarction on postoperative CT in a\u00a0patient that presented with a\u00a0single MeVO on baseline CT-angiography. The primary outcome was good 90-day functional outcome (modified Rankin Scale\u00a00\u20132). Postoperative change in the National Institutes of Health Stroke Scale-score (NIHSS), was a\u00a0secondary outcome. Successfully revascularized patients (mTICI\u00a02b\u20133) were compared with non-revascularized patients in exploratory analyzes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of the 5662 EVTs performed in Sweden (2018\u20132022), 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\u20131.14). Likewise, there was no significant difference in postoperative NIHSS scores (0.26, CI 95% \u22120.71 to 1.24), between groups (<jats:italic>p<\/jats:italic>\u202f=\u20090.597). Successful revascularization was associated with increased chance of good functional outcome for both primary (OR 3.77, CI95% 2.28\u20136.24, <jats:italic>p<\/jats:italic>\u202f&lt;\u20090.001) and secondary MeVOs (OR 2.49, CI95% 1.21\u20135.14, <jats:italic>p<\/jats:italic>\u202f=\u20090.013).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Patients with a\u00a0single 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.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00062-025-01511-w","type":"journal-article","created":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T01:43:32Z","timestamp":1743558212000},"page":"541-549","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Outcomes After Thrombectomy for Primary and Secondary Medium Vessel MCA Occlusions: a\u00a0Nationwide Registry Study"],"prefix":"10.1007","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8661-9063","authenticated-orcid":false,"given":"Bj\u00f6rn M.","family":"Hansen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Hall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitta","family":"Ramgren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Ullberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Wass\u00e9lius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,31]]},"reference":[{"key":"1511_CR1","doi-asserted-by":"publisher","first-page":"1723","DOI":"10.1016\/S0140-6736(16)00163-X","volume":"387","author":"M Goyal","year":"2016","unstructured":"Goyal\u00a0M, Menon\u00a0BK, van Zwam\u00a0WH, Dippel\u00a0DW, Mitchell\u00a0PJ, Demchuk\u00a0AM, D\u00e1valos\u00a0A, Majoie\u00a0CB, van der Lugt\u00a0A, de Miquel\u00a0MA, Donnan\u00a0GA, Roos\u00a0YB, Bonafe\u00a0A, Jahan\u00a0R, Diener\u00a0HC, et\u00a0al. 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T.\u00a0Ullberg received honoraria from Astra Zeneca for an expert group assignment, and speaker honoraria from Siemens Healthineers. B.M.\u00a0Hansen, E.\u00a0Hall, B.\u00a0Ramgren declare that they have no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. The Swedish Ethical Review Authority approved the study and waived individual informed consent (#2019\/00678 and #2022-00890-02).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}}]}}