BACKGROUND AND PURPOSE We investigated the impact of complete recanalization beyond partial recanalization in distal (M2) middle cerebral artery (MCA) occlusion. METHODS Data regarding M2 occlusion patients treated with endovascular thrombectomy (EVT) and/or intravenous thrombolysis (tPA) were reviewed from our prospective EVT registry and multicenter tPA (YAMATO study) data bank. Complete recanalization was modified thrombolysis with cerebral infarction score (TICI) of 3 at the end of EVT or similar appearances of both MCAs on magnetic resonance angiography (MRA) within 1.5 h after tPA. Partial recanalization was defined as TICI ≥2b or > 50% recanalization on MRA. At 3 months, favorable outcome was defined as a modified Rankin Scale score ≤ 2. RESULT Data on 121 patients were analyzed. EVT-alone was in 38 patients; combined EVT and tPA in 28; and tPA-alone in 55. Complete recanalization was achieved in 27 (22%), partial recanalization in 48 (40%), and no-to-limited recanalization in 46 (38%). At 3 months, 51% of patients had favorable outcomes, and this rate was significantly higher in the complete recanalization group than in the partial and no-to-limited recanalization groups (75% vs. 41% vs. 49%, p = .043). Multivariate regression analysis showed that complete recanalization was an independent parameter related to favorable outcomes (odds ratio 4.78, 95% CI: 1.16-19.73, p = .030). However, combined complete and partial recanalization was not associated with favorable outcomes (odds ratio 1.49, 95% CI 0.53-4.22, p = .449). CONCLUSION Complete recanalization, but not partial recanalization, at the end of EVT and tPA therapy is associated with favorable outcomes in patients with M2 occlusion.

中文翻译：

---

M2闭塞心源性卒中患者完全再通对临床恢复的影响

背景和目的 我们研究了在远端 (M2) 大脑中动脉 (MCA) 闭塞中部分再通之外的完全再通的影响。方法 从我们的前瞻性 EVT 注册和多中心 tPA（YAMATO 研究）数据库中审查了有关接受血管内血栓切除术 (EVT) 和/或静脉溶栓 (tPA) 治疗的 M2 闭塞患者的数据。完全再通是改良溶栓治疗，EVT 结束时脑梗死评分 (TICI) 为 3，或 tPA 后 1.5 小时内磁共振血管造影 (MRA) 上两种 MCA 的表现相似。部分再通定义为 TICI ≥ 2b 或 MRA 再通 > 50%。在 3 个月时，良好的结果被定义为改良的 Rankin 量表评分≤ 2。对 121 名患者的结果数据进行了分析。38 名患者仅使用 EVT；在 28 中结合了 EVT 和 tPA；55 名患者接受单独 tPA 治疗。27 名患者 (22%) 实现了完全再通，48 名 (40%) 实现了部分再通，46 名 (38%) 实现了无限制性再通。在 3 个月时，51% 的患者有良好的预后，完全再通组的这一比率显着高于部分再通和非限制性再通组（75% 对 41% 对 49%，p = . 043)。多变量回归分析显示完全再通是与有利结果相关的独立参数（比值比 4.78，95% CI：1.16-19.73，p = .030）。然而，完全和部分再通联合与良好结局无关（比值比 1.49，95% CI 0.53-4.22，p = .449）。结论 完全再通，但不是部分再通，