Abstract Details

Title Mechanical Thrombectomy in Medium Vessel Occlusion: Systematic Review of Efficacy and Outcome Determinants

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P6 - Poster Session 6 (5:00 PM-6:00 PM)

Poster/Presentation
Number 5-012

Objective This study aims to systematically review current evidence on the efficacy of mechanical thrombectomy in medium vessel occlusion (MeVO) stroke and to analyze associated factors that influence clinical and angiographic outcomes.

Background Mechanical thrombectomy (MT) is the treatment of choice for Large vessel occlusion (LVO) in Cerebrovascular accident; however, previous clinical outcomes were unsatisfactory in medium vessel occlusion (MeVO) due to vessel perforation and less accessibility due to small caliber. Given recent advancements and multiple trials, such as the DISCOUNT, TOPMOST, and ESCAPE MeVo trials, demonstrating its efficacy, we aim to investigate the advanced efficacy of MT in MeVO and its effectiveness in relation to associated factors.

Design/Methods We conducted a systematic review following PRISMA guidelines across PubMed and Google Scholar. We included studies if they had effects of mechanical thrombectomy in medium vessel occlusion and associated factors affecting the outcome.

Results Through a literature search, we identified 522 studies, and 30 articles met the inclusion criteria. Fifteen articles met the quality assessment score of at least 70%. These fifteen articles included the factors that affected MT in MeVO outcomes. These factors include the use of anticoagulation, aspirin, the possibility of embolization of new territory, device selection, the technique of MT, functional outcomes, recanalization predictors, prognosis, MT vs medical management, and the first-pass effect. These factors had an effect on MT outcomes in these patients. Each factor has its own independent contribution to the outcome.

Conclusions when performing MT in MeVo, anticoagulation increases the mortality rate, while aspirin improves the outcome. Low passes and attempts of recanalization have shown better outcomes. Device selection and MT technique have unclear outcomes, as limited data are available. Limitations include small sample size, lack of quantification of the impact of each factor on outcomes, and the absence of long-term outcome data.

Authors/Disclosures
Lakshmi Sai Deepak Velugoti PRESENTER	Lakshmi Sai Deepak Velugoti has nothing to disclose.
Lakshmi Vandana R. Chintalapati, MBBS	Miss Chintalapati has nothing to disclose.
Shravya Pingili, MBBS	Miss Pingili has nothing to disclose.
Ayaz M. Khawaja, MD	Dr. Khawaja has nothing to disclose.
Ramesh Madhavan, MD, FAAN (International Medical Clinic)	Dr. Madhavan has received stock or an ownership interest from TiaTech USA and TiaTech India. Dr. Madhavan has received intellectual property interests from a discovery or technology relating to health care.

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