{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T13:53:01Z","timestamp":1777729981589,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T00:00:00Z","timestamp":1749600000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Interv Neuroradiol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mechanical thrombectomy (MT) is an important treatment for middle cerebral artery (MCA) M2 occlusions. However, it carries a risk of intracranial hemorrhage (ICH), especially with a stent retriever. We investigated the correlation between MCA M1 tortuosity and ICH after MT using a stent retriever for M2 occlusions, along with other clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center, retrospective study included patients with isolated MCA M2 occlusions treated using a stent retriever. M1 tortuosity was assessed using pre-MT imaging, with patients classified into tortuous (\u2265 2 angulations) and non-tortuous (\u2264 1 angulation) groups. The primary outcome was any ICH. Secondary outcomes included symptomatic ICH (sICH), procedural outcomes, and functional outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 153 patients (median age: 78 years, 48% female), 55 (36%) had tortuous M1 segments. The tortuous group showed higher NIHSS scores (median score 19 vs. 14,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.045) and a higher prevalence of chronic renal failure at baseline (15% vs. 4%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.029). Any ICH occurred in 69 patients (45%) and was more frequent in the tortuous group (64% vs. 35%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.003; adjusted odds ratio [aOR], 3.09; 95% confidence interval [CI], 1.48\u20136.42). Among the ICH subtypes, subarachnoid hemorrhage (SAH) was more common in the tortuous group (49% vs. 27%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.01; aOR, 2.61; 95% CI, 1.26\u20135.41). However, the incidence of sICH (5.5% vs. 4.1%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.70) and good neurological outcome at 90 days after MT (45% vs. 50%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.62) were comparable.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MCA M1 tortuosity was associated with a higher incidence of any ICH, particularly SAH, after MT using a stent retriever for M2 occlusions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15910199251349879","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T04:16:42Z","timestamp":1749615402000},"page":"229-235","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between M1 tortuosity and intracranial hemorrhage after mechanical thrombectomy using a stent retriever for M2 occlusions"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4005-7436","authenticated-orcid":false,"given":"Rikuo","family":"Nishii","sequence":"first","affiliation":[{"name":"Kobe City Medical Center General Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9007-3945","authenticated-orcid":false,"given":"Satoru","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Kobe City Medical Center General 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