Functional Outcome and Procedure-Related Subarachnoid Hemorrhage in Primary M2 Occlusion: Impact of Initial…

Cohort studyWorld neurosurgery· Aug 2026

Functional Outcome and Procedure-Related Subarachnoid Hemorrhage in Primary M2 Occlusion: Impact of Initial Thrombectomy Strategy and Procedural Factors.

Yuji Nishi, Yuki Sakamoto, Junya Aoki … Satoshi Suda

CerebrovascularCohort studyTreatmentQ2IF 1.8

Subarachnoid hemorrhage was more frequent with stent retriever-first than aspiration-first thrombectomy for M2 occlusion

Functional Outcome and Procedure-Related Subarachnoid Hemorrhage in Primary M2 Occlusion: Impact of Initial Thrombectomy Strategy and Procedural Factors.

Yuji Nishi … Satoshi Suda

World neurosurgery · Aug 2026 · Q2 in Surgery

Background

The optimal thrombectomy strategy for primary middle cerebral artery M2 occlusion remains uncertain, particularly with respect to procedural safety.

Methods

Were classified as contact aspiration first (CA-first) or stent retriever first (SR-first).

n = 52 patients

Results

Procedural bleeding occurred in 39% of stent retriever-first cases versus 18% of aspiration-first cases.

SR-first

39%

CA-first

18%

More results

We retrospectively analyzed 180 consecutive patients with primary M2 occlusion treated with mechanical thrombectomy between January 2011 and August 2025.

Reperfusion success and functional outcome were similar between strategies.

More results

In multivariable analysis, smaller occluded vessel diameter, higher number of device passes, and SR-first strategy were independently associated with subarachnoid hemorrhage.

“

Conclusion

Subarachnoid hemorrhage was associated with worse outcome in univariable but not multivariable analysis, likely reflecting overall procedural complexity and baseline severity rather than an independent effect on outcome.

Functional Outcome and Procedure-Related Subarachnoid Hemorrhage in Primary M2 Occlusion: Impact of Initial Thrombectomy Strategy and Procedural Factors.

Functional Outcome and Procedure-Related Subarachnoid Hemorrhage in Primary M2 Occlusion: Impact of Initial Thrombectomy Strategy and Procedural Factors.

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