Efficacy of Endovascular Treatment for Occlusive Lesions of a Single M2 Branch in Non-recombinant Tissue Plasminogen Activator Treated Patients

Purpose: This study investigated the efficacy of endovascular therapy for occlusion of the second segment (M2) of the middle cerebral artery (MCA) in patients who were ineligible for intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA). Materials and Methods: The subjects were 29 patients with M2 occlusion who were admitted between December 2010 and July 2015. In total, 21 patients were assigned to medical therapy and 8 received endovascular therapy. Results: We compared background factors and the outcome between the two groups. We also assessed the impact of endovascular therapy on the outcome by multivariate analysis. After 90 days, the mean modified Rankin Scale (mRS) score was significantly lower in the endovascular therapy group than in the medical therapy group (1.62 +- 0.50 vs. 3.00 +- 0.31, P = 0.02). Multivariate analysis showed that the age (odds ratio [OR]: 0.83, 95% confidence interval [CI]: 0.61 - 0.99, P = 0.04), the National Institutes of Health Stroke Scale (NIHSS) score on admission (OR: 0.58, 95% CI: 0.27 - 0.83, P < 0.01), and endovascular therapy (OR: 160, 95% CI: 1.28 - 985,014, P = 0.03) were independent predictors of an mRS score