Cerebral regions preserved by successful endovascular recanalization of acute M1 segment occlusions: a voxel based analysis

Objective:To identify cerebral regions preserved by successful recanalization of the middle cerebral artery M1 segment and their association with early clinical outcome.Methods:47 patients who underwent endovascular treatment for acute unilateral M1 segment occlusion were included. Successful recanalization was defined by a modified thrombolysis in cerebral infarction score of 2b/3. Final infarct volumes were segmented on follow-up MRI/CT, 2–7 days post-symptom onset. The differences in topography of infarct lesions associated with successful vs unsuccessful recanalization were assessed using voxel-based analysis. Favourable outcome was defined by a modified Rankin Scale score ≤2 at discharge, and disability/death by score >2.Results:Successful recanalization of M1 segment occlusion was achieved in 26/47 (55%) patients, which was associated with higher rate of favourable outcome (54% vs 9%, p = 0.002) and smaller final infarct volumes (34.3 ± 43.7 vs 98.1 ± 47.7 ml, p < 0.001). In voxel-based analysis, pa...