shinsuke sato    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Assistant Professor
Article types	Original article
Language	English
Peer review	Peer reviewed
Title	Tortuosity of middle cerebral artery M1 segment and outcomes after mechanical thrombectomy.
Journal	Formal name：Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences Abbreviation：Interv Neuroradiol ISSN code：23852011/15910199
Domestic / Foregin	Foregin
Volume, Issue, Page	pp.Online ahead of print
Author and coauthor	Hoshino Takao†, Sato Shinsuke*, Kushi Kazuki, Tanaka Yukiko, Mochizuki Tatsuki, Ishikawa Tomomi, Shima Shogo, Ryu Bikei, Inoue Tatsuya, Okada Yoshikazu, Niimi Yasunari
Authorship	Corresponding author
Publication date	2022/06
Summary	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