• Lorenzo Piergallini, Amedeo Cervo, Antonio Macera, Mariangela Piano, and Guglielmo Pero.
• Postgraduation School of Radiodiagnostics, Università degli Studi di Milano, Milan, Italy; Department of Neuroradiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. Electronic address: lorenzo.piergallini@gmail.com.
• World Neurosurg. 2020 May 1; 137: 425-428.e1.

BackgroundM2 occlusions represent 16%-41% of all middle cerebral artery occlusions, with >50% of functional independence achieved. The American Heart Association/American Stroke Association 2018 guidelines suggest that, with a level of evidence B-R, thrombectomy with stent retrievers may be appropriate for selected patients with M2 or M3 occlusions. The purpose of this study is to illustrate a new technique of distal (M2-M3) thrombectomy.MethodsEight patients from May 2018 to February 2019 underwent a thrombectomy procedure for a M2 or M3 occlusion with a 3MAX or 4MAX intermediate aspiration catheter, a Headway Duo 167 cm microcatheter, and a Catchview Mini stent retriever.ResultsAll thrombectomies were technically successful, defined as thrombolysis in cerebral infarction score ≤2b. Five out of the 8 patients attained a good functional outcome at 3 months, defined as modified Rankin scale score ≤2.ConclusionsThis technique allows a safe and effective distal thrombectomy for M2-M3 occlusions.Copyright © 2020 Elsevier Inc. All rights reserved.

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