{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:24:02Z","timestamp":1790706242279,"version":"4.1.0"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Current evidence provides limited support for the superiority of endovascular thrombectomy (EVT) in patients with M2 segment middle cerebral artery occlusion. We aim to investigate whether imaging features of M2 segment occlusion impact the effectiveness of EVT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study from January 2017 to January 2022, drawing data from the CASE II registry (Computer-Based Online Database of Acute Stroke Patients for Stroke Management Quality Evaluation), which specifically documented patients with acute ischemic stroke presenting with M2 segment occlusion undergoing reperfusion therapy. Patients were stratified into the intravenous thrombolysis (IVT) group (IVT alone) and EVT group (IVT plus EVT or EVT alone). The primary outcome was a modified Rankin Scale score 0 to 2 at 90 days. Secondary outcomes included additional thresholds and distribution of modified Rankin Scale scores, 24-hour recanalization, early neurological deterioration, and relevant complications during hospitalization. Safety outcomes encompassed intracranial hemorrhagic events at 24 hours and mortality at 90 days. Binary logistic regression analyses with propensity score matching were used. Subgroup analyses were performed based on the anatomic site of occlusion, including right versus left, proximal versus distal, dominant\/co-dominant versus nondominant, single versus double\/triple branch(es), and anterior versus central\/posterior branch.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Among 734 patients (43.3% were females; median age, 73 years) with M2 segment occlusion, 342 (46.6%) were in the EVT group. Propensity score matching analysis revealed no statistical difference in the primary outcome (odds ratio, 0.860 [95% CI, 0.611\u20131.209];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.385) between the EVT group and IVT group. However, EVT was associated with a higher incidence of subarachnoid hemorrhage (odds ratio, 6.655 [95% CI, 1.487\u201329.788];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.004) and pneumonia (odds ratio, 2.015 [95% CI, 1.364\u20132.977];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001). Subgroup analyses indicated that patients in the IVT group achieved better outcomes when presenting with right, distal, or nondominant branch occlusion (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      <jats:sub>all interaction<\/jats:sub>\n                      &lt;0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Our study showed similar efficiency of EVT versus IVT alone in acute M2 segment middle cerebral artery occlusion. This suggested that only specific patient subpopulations might have a potentially higher benefit of EVT over IVT alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>REGISTRATION:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\">https:\/\/clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT04487340.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.123.044986","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T14:00:46Z","timestamp":1716559246000},"page":"1592-1600","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Comparing Outcomes of Thrombectomy Versus Intravenous Thrombolysis Based on Middle Cerebral Artery M2 Occlusion Features"],"prefix":"10.1161","volume":"55","clinical-trial-number":[{"clinical-trial-number":"nct04487340","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Huan","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China (H.Z., W.Z., T.Z., J.Y., M.L., S.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wansi","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China (H.Z., W.Z., T.Z., J.Y., M.L., S.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingxia","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China (H.Z., W.Z., T.Z., J.Y., M.L., S.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenghua","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Taizhou First People\u2019s Hospital, China (C.X.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2147-258X","authenticated-orcid":true,"given":"Genlong","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Sixth Affiliated Hospital of Wenzhou Medical University, The People\u2019s Hospital of Lishui, China (G.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5065-1448","authenticated-orcid":true,"given":"Guomin","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ningbo Medical Center Li Huili Hospital, China (G.X.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Huzhou Central Hospital, China (B.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongfang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, China (H.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"En","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, China (E.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongjuan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Dongyang Affiliated Hospital of Wenzhou Medical University, China 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S.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6425-0672","authenticated-orcid":true,"given":"Shenqiang","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Neurology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China (H.Z., W.Z., T.Z., J.Y., M.L., S.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the CASE-II Study 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