J Stroke.  2022 May;24(2):207-223. 10.5853/jos.2022.00941.

Endovascular Treatment for Posterior Circulation Stroke: Ways to Maximize Therapeutic Efficacy

Affiliations
  • 1Department of Neurology, Ajou University School of Medicine, Suwon, Korea
  • 2Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Abstract

The efficacy of endovascular treatment (EVT) in patients with posterior circulation stroke has not been proven. Two recent randomized controlled trials failed to show improved functional outcomes after EVT for posterior circulation stroke (PC-EVT). However, promising results for two additional randomized controlled trials have also been presented at a recent conference. Studies have shown that patients undergoing PC-EVT had a higher rate of futile recanalization than those undergoing EVT for anterior circulation stroke. These findings call for further identification of prognostic factors beyond recanalization. The significance of baseline clinical severity, infarct volume, collaterals, time metrics, core-penumbra mismatch, and methods to accurately measure these parameters are discussed. Furthermore, their interplay on EVT outcomes and the potential to individualize patient selection for PC-EVT are reviewed. We also discuss technical considerations for improving the treatment efficacy of PC-EVT.

Keyword

Cerebral infarction; Posterior circulation; Endovascular treatment; Mechanical thrombectomy; Basilar artery occlusion; Vertebrobasilar artery occlusion

Cited by  3 articles

Resurrection of Endovascular Thrombectomy for Posterior Circulation Stroke
Jong S. Kim
J Stroke. 2022;24(2):177-178.    doi: 10.5853/jos.2022.01620.

Collateral Circulation in Ischemic Stroke: An Updated Review
Gino Maguida, Ashfaq Shuaib
J Stroke. 2023;25(2):179-198.    doi: 10.5853/jos.2022.02936.

A Review of Endovascular Treatment for Posterior Circulation Strokes
Sung Hyun Baik, Jun Yup Kim, Cheolkyu Jung
Neurointervention. 2023;18(2):90-106.    doi: 10.5469/neuroint.2023.00213.


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