Clinical outcomes and independently adjudicated results of M2 aspiration thrombectomy: a subgroup analysis from the Imperative Trial

作者：Justin Mascitelli, Reade De Leacy, William J. Mack, Raul G. Nogueira, Shahram Majidi, Robert Dana Tomalty, Maxim Mokin, Jan Vargas, Brett Cucchiara, Kenneth V. Snyder, Victoria Parada, Hakeem J Shakir, David Rosenbaum-Halevi, Amin Aghaebrahim, Daniel Hoit, Benjamin Yim, Matthew Tenser, Alhamza R Al‐Bayati, James Milburn, Shahid M. Nimjee, Neil Haranhalli, Michael Nahhas, Darryn Shaff, Kennith F. Layton, Narlin Beaty, Robert M. Starke, Harris Hawk, Diogo C Haussen, Aqueel Pabaney, Christopher P. Kellner, Jonathan A Grossberg · 发表于：Journal of NeuroInterventional Surgery · 年份：2025 · DOI：10.1136/jnis-2025-024023 · 被引用次数：4 · 研究领域：Acute Ischemic Stroke Management、Intracerebral and Subarachnoid Hemorrhage Research、Peripheral Artery Disease Management

BACKGROUND: The ESCAPE-MeVO (Endovascular Treatment to Improve Outcomes for Medium Vessel Occlusions) and DISTAL (Endovascular Therapy plus Best Medical Treatment vs Best Medical Treatment Alone for Medium Vessel Occlusion Stroke) trials failed to demonstrate the superiority of endovascular thrombectomy over best medical management for medium and small vessel occlusions. Potential limitations of these trials include older patient populations, lower presenting National Institutes of Health Stroke Scale (NIHSS) scores, higher rates of premorbid disability, delayed revascularization times, inclusion of both medium and small vessel occlusions, and widespread use of stent retrievers. Here we present M2 occlusion data from the Imperative Trial, evaluating aspiration thrombectomy with the Zoom System. METHODS: The Imperative Trial is a prospective, multicenter, single-arm trial with independent core lab and safety board adjudication, evaluating aspiration thrombectomy with the Zoom System (Imperative Care, Campbell, CA, USA) for large vessel, including M2, occlusions. This subanalysis includes patients with primary M2 occlusions. Angiographic outcomes were defined as modified Treatment in Cerebral Infarction (mTICI) score ≥2b (good) and ≥2c (excellent). Clinical outcomes were defined as modified Rankin Scale score (mRS) 0-2 (good) and 0-1 (excellent) at 90 days. Safety was assessed by all-cause mortality, symptomatic intracranial hemorrhage (sICH), and all hemorrhage. RESULTS: Of 26...