Efficacy and safety of mechanical thrombectomy in the posterior cerebral circulation-a single center study

Abstract

Mechanical thrombectomy (MT) is the current standard treatment for strokes in the anterior cerebral circulation (AMT) and has recently been proven to be beneficial in the posterior circulation strokes (PMT). Our study aims to evaluate parameters for favorable outcomes in PMT-patients and to compare the clinical characteristics of individuals who received AMT and PMT. For this purpose, we confronted AMT and PMT-receipients and performed a multivariate regression analysis to assess the influence of factors on favorable outcomes in the study group and in the AMT and PMT subgroups. When analysing 623 MT-patients, those who received PMT had significantly lower admission National Institutes of Health Stroke Scale (NIHSS) scores (9 vs. 13; p < 0.001) and 24 h post-MT (7 vs. 12; p = 0.006). Key parameters influencing the favorable outcomes of PMT at discharge and at 90th day include: NIHSS scores (OR: 0.865, 95% CI: 0.813-0.893, and OR: 0.900, 95% CI: 0.861-0.925), MT time (OR: 0.993, 95% CI: 0.987-0.998 and OR: 0.993, 95% CI: 0.990-0.997), and leukocytosis (OR: 0.961, 95% CI: 0.928-0.988 and OR: 0.974, 95% CI: 0.957-0.998). Different clinical profiles exist between AMT and PMT-recipients, with the neurological status post-MT being decisive for the prognosis. Several factors play an important role in predicting outcome, especially in the PMT group.

Keywords: Anterior circulation; Mechanical thrombectomy; Outcomes; Posterior circulation; Stroke.

Figure 1

Comparison of outcomes in patients with PMT and AMT at discharge and at 90th day of stroke. AMT anterior mechanical thrombectomy, PMT posterior mechanical thrombectomy, MT mechanical thrombectomy, mRS modified Rankin Scale.