Evaluation the effectiveness of mechanical thrombectomy in acute ischemic stroke patients with occlusion in the M2 and/or M3 segments of the middle cerebral artery

Objective: Acute ischemic stroke is a neurological emergency caused by the occlusion of cerebral arteries, leading to loss of neurological function and requiring urgent intervention. Mechanical thrombectomy (MT) has become the standard treatment for large vessel occlusions due to its proven efficacy. However, the effectiveness of thrombectomy in middle cerebral artery (MCA) M2 and M3 segment occlusions remains controversial. This study aims to evaluate the effectiveness, clinical outcomes, and complications of mechanical thrombectomy in patients with MCA M2/M3 segment occlusions. Methods: In this retrospective study, patients diagnosed with acute ischemic stroke and detected with MCA M2/M3 segment occlusions who were admitted to Harran University Hospital between January 2021 and December 2023 were analyzed. The demographic data, pre- and post-stroke neurological status, thrombectomy method, revascularization success, and functional improvement rates were evaluated. Revascularization success was assessed using the Thrombolysis in Cerebral Infarction (TICI) score, while functional independence rates were evaluated using the modified Rankin Scale (mRS). Complications, procedural failures, and mortality rates were also recorded. Results: The mean age of the included patients was 69.7±12.2 years, with 46.9% of them being male. The successful revascularization rate after mechanical thrombectomy was 81.6%. According to the mRS score, the proportion of patients achieving sufficient clinical success at 90 days was 71.4%. The mean ASPECT score for all patients was 9.1±0.9, while the mean NIHSS score was 14.4±4.2. The most common post-procedure complications were hemorrhage, vascular dissection, and embolization. The results were compared with similar studies in the literature. Conclusion: This study suggests that mechanical thrombectomy may be an effective treatment option for selected patients with MCA M2/M3 segment occlusions. However, due to high complication rates and the need to determine optimal treatment strategies, further large-scale, prospective studies are required. The safety and clinical outcomes of thrombectomy in the distal MCA segments should be further investigated through comprehensive research.