Research Papers:

Distance to Thrombus in acute middle cerebral artery stroke predicts basal ganglia infarction after mechanical thrombectomy

Benjamin Friedrich _, Donald Lobsien, Christian Maegerlein, Silke Wunderlich, Claus Zimmer, Johannes Kaesmacher and Justus Kleine

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Oncotarget. 2016; 7:85813-85818. https://doi.org/10.18632/oncotarget.13280

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Benjamin Friedrich1, Donald Lobsien2, Christian Maegerlein1, Silke Wunderlich3, Claus Zimmer1, Johannes Kaesmacher1,* and Justus Kleine1,*

1 Department of diagnostic and interventional Neuroradiology, Klinikum rechts der Isar, Munich, Germany

2 Department of Neuroradiology, University Hospital Leipzig, Leipzig, Germany

3 Department of Neurology, Klinikum rechts der Isar, Munich, Germany

* These authors have contributed equally to the present study

Correspondence to:

Benjamin Friedrich, email:

Keywords: distance to thrombus, stroke, basal ganglia, mechanical thrombectomy

Received: September 30, 2016 Accepted: October 28, 2016 Published: November 10, 2016


Background and Purpose: This study examines if involvement of the lenticulostriate arteries (LSAs) in MCA stroke and consecutive infarction of the basal ganglia can be predicted by the exact occlusion site, as determined in pre-interventional CT or MRI imaging.

Methods: Retrospective analysis of 212 patients with acute isolated MCA occlusions treated with mechanical thrombectomy. The occlusion site was assessed using the Distance to Thrombus (DT). Affection of LSAs by the occlusion was determined by analysis of pre- and post-interventional DSA runs. Infarction of the striatocapsular region was evaluated in post-interventional imaging.

Results: DT showed a highly significant correlation with the affected LSA group (ρ = 0.747; P < 0.001). In a ROC analysis, DT could predict affection of the LSAs with an area under the curve (AUC) of 0.903. Additionally, DT could predict an infarction of the striatocapsular region with an AUC of 0.824. In a stepwise regression analysis for striatocapsular infarction including DT, age, time from symptom onset to recanalization and recanalization success, only DT proved to be an independent predictor.

Conclusion: In MCA stroke, the exact site of the occlusion as measured by DT independently predicts the involvement of LSAs and subsequent striatocapsular infarction with high sensitivity and specificity.

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