Endovascular Treatment Decisions in Patients with M2 Segment MCA Occlusions

Endovascular therapy in acute ischemic stroke is rapidly evolving. We explored physicians' treatment attitudes and practice in patients with acute ischemic stroke due to M2 occlusion, given the absence of Level-1 guidelines. We conducted an international multidisciplinary survey among physician...

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Bibliographic Details
Published in:American journal of neuroradiology : AJNR 2020-02, Vol.41 (2), p.280-285
Main Authors: Almekhlafi, M, Ospel, J M, Saposnik, G, Kashani, N, Demchuk, A, Hill, M D, Goyal, M, Menon, B K
Format: Article
Language:English
Subjects:
Adult
Aged
Cross-Sectional Studies
Endovascular Procedures
Female
Health Knowledge, Attitudes, Practice
Humans
Infarction, Middle Cerebral Artery - surgery
Interventional
Male
Middle Aged
Practice Patterns, Physicians' - statistics & numerical data
Surveys and Questionnaires
Treatment Outcome
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Summary:Endovascular therapy in acute ischemic stroke is rapidly evolving. We explored physicians' treatment attitudes and practice in patients with acute ischemic stroke due to M2 occlusion, given the absence of Level-1 guidelines. We conducted an international multidisciplinary survey among physicians involved in acute stroke care. Respondents were presented with 10 of 22 case scenarios (4 with proximal M2 occlusions and 1 with a small-branch M2 occlusion) and asked about their treatment approach under A) current local resources, and B) assumed ideal conditions (no monetary or infrastructural restraints). Overall treatment decisions were evaluated; subgroup analyses by physician and patient baseline characteristics were performed. A total of 607 physicians participated. Most of the respondents decided in favor of endovascular therapy in M2 occlusions, both under current local resources and assumed ideal conditions (65.4% versus 69.6%; = .017). Under current local resources, older patient age (
ISSN:0195-6108
1936-959X
DOI:10.3174/ajnr.A6397