Evaluation of Mechanical Thrombectomy in Acute Ischemic Stroke Related to a Distal Arterial Occlusion

Inclusion Criteria: * Patients aged ≥ 18 years * Delay between symptoms onset and expected groin puncture ≤ 6 h * Symptomatic occlusion as evaluated by a National Institute of Health Stroke Score (NIHSS) ≥ 5 * Distal occlusion evaluated on CT angiography (CTA) or magnetic resonance imaging (MRI) and defined as an occlusion in one of the following segments: * Distal M2, above the mid-height of the insula * M3 segment * Posterior cerebral artery (PCA): P1, P2, P3 segments * Anterior cerebral artery (ACA): A1, A2, A3 segments * Written informed consent signed by the patient or the trustworthy person / family member / close relative, or inclusion in case of emergency and written informed consent will be signed by the patient (if needed by trustworthy person, family member or close relative) as soon as possible (article L1122-1-2 of the French Public Health Code) Exclusion Criteria: * Pregnancy or breastfeeding woman * Contra-indication for femoral, radial or humeral arterial puncture * Tandem occlusion (i.e.: concomitant cervical and intra-cranial arterial occlusion) * Allergy to iodinated contrast media * Known renal insufficiency (confirmed by previous result of creatinine clearance \< 30 ml/min) * Secondary distal occlusion (i.e., complicating a MT for a proximal occlusion, or any other endovascular intracranial procedure) * Aortic dissection * Asymptomatic or minor stroke (i.e.: NIHSS \< 5) * Pretreatment mRS \> 1 (pre-stroke) * Anticipated limitations for anesthe…