サトウ　シンスケ   Satou Shinsuke   佐藤　慎祐    所属   医学部 医学科（東京女子医科大学病院）    職種   助教
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Tortuosity of middle cerebral artery M1 segment and outcomes after mechanical thrombectomy.
掲載誌名	正式名：Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences 略　 称：Interv Neuroradiol ISSNコード：23852011/15910199
掲載区分	国外
巻・号・頁	pp.Online ahead of print
著者・共著者	Hoshino Takao†, Sato Shinsuke*, Kushi Kazuki, Tanaka Yukiko, Mochizuki Tatsuki, Ishikawa Tomomi, Shima Shogo, Ryu Bikei, Inoue Tatsuya, Okada Yoshikazu, Niimi Yasunari
担当区分	責任著者
発行年月	2022/06
概要	BACKGROUND:We aimed to quantify the tortuosity of the middle cerebral artery (MCA) and assess its effects on radiological and clinical outcomes in patients with acute MCA occlusions who received mechanical thrombectomy (MT).METHODS:This retrospective study enrolled 53 patients with acute ischemic stroke due to MCA M1 or M2 segment occlusion who underwent MT using stent retrievers (SRs). Tortuosity index (TI) was defined to quantify the tortuosity of the MCA M1 segment using the following formula: (actual distance / straight distance) × 100. For each patient, four TIs were measured in the anteroposterior and caudal views for both ipsilateral and contralateral sides to the occluded site (TI-APi, TI-APc, TI-CAUi, and TI-CAUc, respectively) using magnetic resonance angiography (MRA) or computed tomography angiography (CTA). We defined the first-pass effect (FPE) as first-pass mTICI classification ≥2b reperfusion.RESULTS:Patients who did not achieve FPE had significantly higher TI-APi (112 vs. 106; P = 0.004), TI-APc (111 vs. 105; P = 0.005), TI-CAUi (110 vs. 105; P = 0.002), and TI-CAUc (110 vs. 105; P = 0.001) than those who achieved FPE. In multivariable analysis, higher TI-APi, TI-CAUi, and TI-APc were independently associated with an increased rate of unsuccessful FPE (odds ratio (OR) [95% confidence interval (CI)]: 1.25 [1.02-1.61], 1.21 [1.01-1.45], and 1.27 [1.03-1.73], respectively). TI-CAUi, TI-APc, and TI-CAUc were also independent predictors of the occurrence of intracranial hemorrhage after MT (OR [95% CI]: 1.15 [1.01-1.38], 1.14 [1.01-1.38], 1.25 [1.02-1.52], respectively).CONCLUSIONS:The TIs of the MCA M1 segment on both ipsilateral and contralateral sides were associated with unfavourable outcomes after MT.
DOI	10.1177/15910199221104922
PMID	35656743