Sagittal M2 tortuosity index on routine CTA linked to lower complete recanalization odds in distal M2 thrombectomy

In distal M2 thrombectomy, a sagittal tortuosity index ≥1.19 on baseline CTA was associated with a lower complete recanalization rate (mTICI 3: 39% vs 70%), fewer first-pass effects (11% vs 39%), and reduced 90-day functional independence (adjusted OR 0.11; 95%CI 0.02–0.53). Ext…

• Retrospective cohort of 51 patients undergoing distal M2 thrombectomy (2023–2024); two blinded readers assessed CTA anatomy.
• High sagittal tortuosity (≥1.19) independently predicted lower odds of complete recanalization (adjusted OR 0.18; 95%CI 0.04–0.74; p=0.02) and more device passes (median increase 1.0, p=0.04).
• Limitations: small single-center retrospective study with exploratory data-driven cutoff; requires external validation before clinical application.

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