{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T01:21:19Z","timestamp":1789521679801,"version":"build-2803163510"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>It is unclear whether endovascular treatment (EVT) is beneficial for patients with acute ischemic stroke with occlusion of the M2 segment of the middle cerebral artery. We aimed to compare functional outcomes, technical aspects, and complications of EVT between patients with acute ischemic stroke because of M2 and M1 occlusions in clinical practice. Furthermore, outcome and complications after EVT in dominant and nondominant caliber M2 division occlusions were studied.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>Data were obtained from the MR CLEAN Registry (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) which is an ongoing observational study in 16 Dutch centers performing EVT in the Netherlands. Functional outcome was measured with the modified Rankin Scale score at 90 days. Neurological recovery (delta National Institutes of Health Stroke Scale), successful reperfusion rates (extended Thrombolysis in Cerebral Infarction \u22652B), and safety outcomes were also investigated. Associations between occlusion location and outcome were analyzed with ordinal logistic regression models, with adjustment for other prognostic factors.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>\n              In total, 244 (24%) patients with an M2 and 759 (76%) patients with an M1 occlusion who underwent EVT were analyzed. Functional outcomes were not significantly different between patients with M2 versus M1 occlusions (adjusted common odds ratio, 1.24; 95% CI, 0.87\u20131.73). Occurrence of symptomatic intracerebral hemorrhage was also similar for M2 and M1 occlusions (6.6% versus 5.9%;\n              <jats:italic>P<\/jats:italic>\n              =0.84). Further analysis about dominance of an M2 branch was performed in 175 (72%) patients. Neurological recovery was comparable (mean delta National Institutes of Health Stroke Scale, \u22122\u00b110 for dominant M2, \u22125\u00b15 for nondominant M2, and \u22124\u00b19 [\n              <jats:italic>P<\/jats:italic>\n              =0.24] for M1 occlusions). Furthermore, the effect of reperfusion status on functional outcome was comparable between occlusion divisions (common odds ratio, 1.27; 95% CI, 1.06\u20131.53 for dominant M2; common odds ratio, 1.32; 95% CI, 0.93\u20131.87 for nondominant M2; and common odds ratio, 1.35; 95% CI, 1.24\u20131.46 for M1 occlusions).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Outcomes and complication rates after EVT were similar in patients with M2 and M1 occlusions. Although based on observational data and a limited sample size, a similar association of reperfusion status with functional outcome for all subgroups provides no evidence that patients with either a dominant or a nondominant M2 occlusion should be routinely excluded from EVT.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.118.023117","type":"journal-article","created":{"date-parts":[[2019,1,21]],"date-time":"2019-01-21T10:10:29Z","timestamp":1548065429000},"page":"419-427","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":45,"title":["Endovascular Treatment"],"prefix":"10.1161","volume":"50","author":[{"given":"Kars C.J.","family":"Compagne","sequence":"first","affiliation":[{"name":"From the Department of Radiology and Nuclear Medicine (K.C.J.C., P.M.v.d.S., A.v.d.L., A.C.G.M.v.E.), Erasmus MC, University Medical Center, Rotterdam, the Netherlands"},{"name":"Department of Neurology (K.C.J.C., B.R., M.J.H.L.M., D.W.J.D.), Erasmus MC, University Medical Center, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter M.","family":"van der Sluijs","sequence":"additional","affiliation":[{"name":"From the Department of Radiology and Nuclear Medicine (K.C.J.C., P.M.v.d.S., A.v.d.L., A.C.G.M.v.E.), Erasmus MC, University Medical Center, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ido R.","family":"van den Wijngaard","sequence":"additional","affiliation":[{"name":"Department of Neurology (I.R.v.d.W.), Haaglanden Medical Center (HMC), The Hague, the Netherlands"},{"name":"Department of Neurology, Leiden University Medical Center, the Netherlands (I.R.v.d.W.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bob","family":"Roozenbeek","sequence":"additional","affiliation":[{"name":"Department of Neurology (K.C.J.C., B.R., M.J.H.L.M., D.W.J.D.), Erasmus MC, University Medical Center, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxim J.H.L.","family":"Mulder","sequence":"additional","affiliation":[{"name":"Department of Neurology (K.C.J.C., B.R., M.J.H.L.M., D.W.J.D.), Erasmus MC, University Medical Center, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim H.","family":"van Zwam","sequence":"additional","affiliation":[{"name":"Department of Radiology, Maastricht University Medical Center, the Netherlands (W.H.v.Z.)"},{"name":"Cardiovascular Research Institute Maastricht, the Netherlands (W.H.v.Z.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart J.","family":"Emmer","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, the Netherlands (B.J.E., C.B.L.M.M.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles B.L.M.","family":"Majoie","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, the Netherlands (B.J.E., C.B.L.M.M.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert J.","family":"Yoo","sequence":"additional","affiliation":[{"name":"Division of Neurointervention, Texas Stroke Institute, Dallas-Fort Worth (A.J.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geert J.","family":"Lycklama \u00e0 Nijeholt","sequence":"additional","affiliation":[{"name":"Department of Radiology (G.J.L.\u00e0.N.), Haaglanden Medical Center (HMC), The Hague, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hester F.","family":"Lingsma","sequence":"additional","affiliation":[{"name":"Department of Public Health (H.F.L.), Erasmus MC, University Medical Center, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diederik W.J.","family":"Dippel","sequence":"additional","affiliation":[{"name":"Department of Neurology (K.C.J.C., B.R., M.J.H.L.M., D.W.J.D.), Erasmus MC, University Medical Center, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aad","family":"van der Lugt","sequence":"additional","affiliation":[{"name":"From the Department of Radiology and Nuclear Medicine (K.C.J.C., P.M.v.d.S., A.v.d.L., A.C.G.M.v.E.), Erasmus MC, University Medical Center, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriaan C.G.M.","family":"van Es","sequence":"additional","affiliation":[{"name":"From the Department of Radiology and Nuclear Medicine (K.C.J.C., P.M.v.d.S., A.v.d.L., A.C.G.M.v.E.), Erasmus MC, University Medical Center, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvo B.W.E.M.","family":"Roos","sequence":"additional","affiliation":[{"name":"Department of Neurology (Y.B.W.E.M.R., J.M.C., R.S.), Amsterdam University Medical Center, University of Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"van Oostenbrugge","sequence":"additional","affiliation":[{"name":"Department of Neurology (R.J.v.O., R.-J.B.G., J.S., M.W., D.J.), Maastricht University Medical Center and Cardiovascular Research Institute Maastricht (CARIM), the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelis","family":"Boiten","sequence":"additional","affiliation":[{"name":"Department of Neurology (J.B., J.d.M., T.V.), Haaglanden MC, The Hague, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Albert","family":"Vos","sequence":"additional","affiliation":[{"name":"Department of Radiology (J.A.V.), Sint Antonius Hospital, Nieuwegein, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivo G.H.","family":"Jansen","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine (C.B.L.M.M., I.G.H.J., M.E.S.S., R.v.d.B., L.F.M.B., S.D.R., B.J.E., R.R.G., O.A.B., A.M.M.B., J.H., P.F.C.G., M.A.M., K.R.v.K., K.M.T., M.K., M.L.T., H.A.), Amsterdam University Medical Center, University of Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert-Jan B.","family":"Goldhoorn","sequence":"additional","affiliation":[{"name":"Department of Neurology (R.J.v.O., R.-J.B.G., J.S., M.W., D.J.), Maastricht University Medical Center and Cardiovascular Research Institute Maastricht (CARIM), the Netherlands"},{"name":"Department of Radiology (W.H.v.Z., R.-J.B.G., A.A.P., O.A.B.), Maastricht University Medical Center and Cardiovascular Research Institute Maastricht (CARIM), the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wouter J.","family":"Schonewille","sequence":"additional","affiliation":[{"name":"Department of Neurology (W.J.S., C.P., W.P., W.H.), Sint Antonius Hospital, Nieuwegein, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Albert","family":"Vos","sequence":"additional","affiliation":[{"name":"Department of Radiology (J.A.V.), Sint Antonius Hospital, Nieuwegein, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan M.","family":"Coutinho","sequence":"additional","affiliation":[{"name":"Department of Neurology (Y.B.W.E.M.R., J.M.C., R.S.), Amsterdam University Medical Center, University of Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marieke J.H.","family":"Wermer","sequence":"additional","affiliation":[{"name":"Department of Neurology (M.J.H.W., E.B.), Leiden University Medical Center, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne A.A.","family":"van Walderveen","sequence":"additional","affiliation":[{"name":"Department of Radiology (M.A.A.v.W.), Leiden University Medical Center, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Staals","sequence":"additional","affiliation":[{"name":"Department of Neurology (R.J.v.O., R.-J.B.G., J.S., M.W., D.J.), Maastricht University Medical Center and Cardiovascular Research Institute Maastricht (CARIM), the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannette","family":"Hofmeijer","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine (C.B.L.M.M., I.G.H.J., M.E.S.S., R.v.d.B., L.F.M.B., S.D.R., B.J.E., R.R.G., O.A.B., A.M.M.B., J.H., P.F.C.G., M.A.M., K.R.v.K., K.M.T., M.K., M.L.T., H.A.), Amsterdam University Medical Center, University of Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasper M.","family":"Martens","sequence":"additional","affiliation":[{"name":"Department of Radiology (J.M.M.), Rijnstate Hospital, Arnhem, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelis","family":"Boiten","sequence":"additional","affiliation":[{"name":"Department of Neurology (J.B., J.d.M., T.V.), Haaglanden MC, The Hague, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastiaan F.","family":"de Bruijn","sequence":"additional","affiliation":[{"name":"Department of Neurology (S.F.d.B., Y.D., M.K.), HAGA Hospital, The Hague, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas C.","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Department of Radiology (L.C.v.D.), HAGA Hospital, The Hague, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Bart","family":"van der Worp","sequence":"additional","affiliation":[{"name":"Department of Neurology (H.B.v.d.W., B.Z.), University Medical Center, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob H.","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Radiology (R.H.L.), University Medical Center, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewoud J.","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Department of Neurology (E.J.v.D., A.G., T.v.S.), Radboud University Medical Center, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hieronymus D.","family":"Boogaarts","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery (H.D.B.), Radboud University Medical Center, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul L.M.","family":"de Kort","sequence":"additional","affiliation":[{"name":"Department of Neurology (P.L.M.d.K., C.v.R.), Sint Elisabeth Hospital, Tilburg, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo J.P.","family":"Peluso","sequence":"additional","affiliation":[{"name":"Department of Radiology (J.J.P.P.), Sint Elisabeth Hospital, Tilburg, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan S.P.","family":"van den Berg","sequence":"additional","affiliation":[{"name":"Department of Neurology (J.S.P.v.d.B., H.M.d.H., G.v.V.), Isala Klinieken, Zwolle, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boudewijn A.A.M.","family":"van Hasselt","sequence":"additional","affiliation":[{"name":"Department of Radiology (B.A.A.M.v.H., H.Z.F.), Isala Klinieken, Zwolle, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leo A.M.","family":"Aerden","sequence":"additional","affiliation":[{"name":"Department of Neurology (L.A.M.A., K.B.), Reinier de Graaf Gasthuis, Delft, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9 J.","family":"Dallinga","sequence":"additional","affiliation":[{"name":"Department of Radiology (R.J.D.), Reinier de Graaf Gasthuis, Delft, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten","family":"Uyttenboogaart","sequence":"additional","affiliation":[{"name":"Department of Neurology (M.U., G.M.), University Medical Center Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omid","family":"Eshghi","sequence":"additional","affiliation":[{"name":"Department of Radiology (O.E.), University Medical Center Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobien H.C.M.L.","family":"Schreuder","sequence":"additional","affiliation":[{"name":"Department of Neurology (T.H.C.M.L.S., T.S.), Atrium Medical Center, Heerlen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roel J.J.","family":"Heijboer","sequence":"additional","affiliation":[{"name":"Department of Radiology (R.J.J.H.), Atrium Medical Center, Heerlen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koos","family":"Keizer","sequence":"additional","affiliation":[{"name":"Department of Neurology (K.K., H.B.), Catharina Hospital, Eindhoven, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lonneke S.F.","family":"Yo","sequence":"additional","affiliation":[{"name":"Department of Radiology (L.S.F.Y.), Catharina Hospital, Eindhoven, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heleen M.","family":"den Hertog","sequence":"additional","affiliation":[{"name":"Department of Neurology (J.S.P.v.d.B., H.M.d.H., G.v.V.), Isala Klinieken, Zwolle, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emiel J.C.","family":"Sturm","sequence":"additional","affiliation":[{"name":"Department of Radiology (E.J.C.S.), Medical Spectrum Twente, Enschede, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne A.A.","family":"van Walderveen","sequence":"additional","affiliation":[{"name":"Department of Radiology (M.A.A.v.W.), Leiden University Medical Center, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marieke E.S.","family":"Sprengers","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine (C.B.L.M.M., I.G.H.J., M.E.S.S., R.v.d.B., L.F.M.B., S.D.R., B.J.E., R.R.G., O.A.B., A.M.M.B., J.H., P.F.C.G., M.A.M., K.R.v.K., K.M.T., M.K., M.L.T., H.A.), Amsterdam University Medical Center, University of Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sjoerd F.M.","family":"Jenniskens","sequence":"additional","affiliation":[{"name":"Department of Radiology (S.F.M.J.), Radboud University Medical Center, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9","family":"van den Berg","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine (C.B.L.M.M., I.G.H.J., M.E.S.S., R.v.d.B., L.F.M.B., S.D.R., B.J.E., R.R.G., O.A.B., A.M.M.B., J.H., P.F.C.G., M.A.M., K.R.v.K., K.M.T., M.K., M.L.T., H.A.), Amsterdam University Medical Center, University of Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludo F.M.","family":"Beenen","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine (C.B.L.M.M., I.G.H.J., M.E.S.S., R.v.d.B., L.F.M.B., S.D.R., B.J.E., R.R.G., 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Amsterdam University Medical Center, Vrije Universiteit van Amsterdam, the Netherlands (J.B.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter-Jan","family":"van Doormaal","sequence":"additional","affiliation":[{"name":"Department of Radiology (A.v.d.L., M.J.H.L.M., B.J.E., A.C.G.M.v.E., P.-J.v.D., K.C.J.C.), Erasmus MC University Medical Center, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvo B.W.E.M.","family":"Roos","sequence":"additional","affiliation":[{"name":"Department of Neurology (Y.B.W.E.M.R., J.M.C., R.S.), Amsterdam University Medical Center, University of Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"van Oostenbrugge","sequence":"additional","affiliation":[{"name":"Department of Neurology (R.J.v.O., R.-J.B.G., J.S., M.W., D.J.), Maastricht University Medical Center and Cardiovascular Research Institute Maastricht (CARIM), the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelis","family":"Boiten","sequence":"additional","affiliation":[{"name":"Department of Neurology (J.B., J.d.M., T.V.), Haaglanden MC, The Hague, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Albert","family":"Vos","sequence":"additional","affiliation":[{"name":"Department of Radiology (J.A.V.), Sint Antonius Hospital, Nieuwegein, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wouter J.","family":"Schonewille","sequence":"additional","affiliation":[{"name":"Department of Neurology (W.J.S., C.P., W.P., W.H.), Sint Antonius Hospital, Nieuwegein, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannette","family":"Hofmeijer","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine (C.B.L.M.M., I.G.H.J., M.E.S.S., R.v.d.B., L.F.M.B., S.D.R., B.J.E., R.R.G., O.A.B., A.M.M.B., 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