553 Mechanical Thrombectomy for the Treatment of Anterior Cerebral Artery Occlusion. (April 2023)

• Record Type: Journal Article
• Authors: Dabhi, Nisha; Mastorakos, Panagiotis; Sokolowski, Jennifer D.; Kellogg, Ryan Thomson; Park, Min S.
• Is Part Of: Neurosurgery. Volume 69(2023)Supplement 1
• Page Start: 121
• Page End: 121
• Publication Date: 2023-04
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1227/neu.0000000000002375_553
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract : INTRODUCTION: Strokes of the anterior cerebral artery (ACA) and its branches account for up to 4.4% of ischemic strokes and have been associated with disability after discharge. While mechanical thrombectomy (MT) has been established to be safe and highly effective in the treatment of thromboembolic occlusion of the middle cerebral artery, internal carotid artery, and basilar artery, to date, the safety and efficiency of MT for the treatment of acute ACA occlusions have not been clearly delineated. METHODS: A systematic literature review was performed for outcomes data in patients with MT-treated ACA occlusions using Pubmed, Ovid Medline, and Web of Science. Recanalization, procedural data, and clinical outcome at last follow-up were collected and summarized. RESULTS: In the nine included studies, there were 196 patients with ACA strokes treated with MT, of which 65% (109/168), 34% (57/168), and 33% (56/168) had primary isolated ACA occlusion, primary combined ACA occlusion, and secondary ACA occlusion, respectively. Recanalization mTICI2b/3 was achieved in 80% (134/168), and procedural complications occurred in 23% (39/168) of patients. At the three-month follow-up, mortality rate was 19% (20/106) and rate of good functional outcome was 32% (48/148). CONCLUSIONS: MT for the treatment of ACA occlusions is a relatively safe and efficacious option, offering a favorable rate of recanalization and procedural complications. However, MT-treated ACA occlusions are associated with a lower rate of short-term good functional outcome. More single and multicenter studies are needed to further examine the safety and efficacy of MT in ACA occlusions.