Journal article
Clinical and Procedural Predictors of Outcomes From the Endovascular Treatment of Posterior Circulation Strokes
Stroke (1970), v 47(3), pp 782-788
01 Mar 2016
PMID: 26888533
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Abstract
Patients with posterior circulation strokes have been excluded from recent randomized endovascular stroke trials. We reviewed the recent multicenter experience with endovascular treatment of posterior circulation strokes to identify the clinical, radiographic, and procedural predictors of successful recanalization and good neurological outcomes.
We performed a multicenter retrospective analysis of consecutive patients with posterior circulation strokes, who underwent thrombectomy with stent retrievers or primary aspiration thrombectomy (including A Direct Aspiration First Pass Technique [ADAPT] approach). We correlated clinical and radiographic outcomes with demographic, clinical, and technical characteristics.
A total of 100 patients were included in the final analysis (mean age, 63.5±14.2 years; mean admission National Institutes of Health Stroke Scale score, 19.2±8.2). Favorable clinical outcome at 3 months (modified Rankin Scale score ≤2) was achieved in 35% of patients. Successful recanalization and shorter time from stroke onset to the start of the procedure were significant predictors of favorable clinical outcome at 90 days. Stent retriever and aspiration thrombectomy as primary treatment approaches showed comparable procedural and clinical outcomes. None of the baseline advanced imaging modalities (magnetic resonance imaging, computed tomographic perfusion, or computed tomography angiography assessment of collaterals) showed superiority in selecting patients for thrombectomy.
Time to the start of the procedure is an important predictor of clinical success after thrombectomy in patients with posterior circulation strokes. Both stent retriever and aspiration thrombectomy as primary treatment approaches are effective in achieving successful recanalization.
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Details
- Title
- Clinical and Procedural Predictors of Outcomes From the Endovascular Treatment of Posterior Circulation Strokes
- Creators
- Maxim Mokin - University of South FloridaAshish Sonig - Capital HealthSananthan Sivakanthan - Baylor College of MedicineZeguang Ren - Baylor College of MedicineLucas Elijovich - Baylor College of MedicineAdam Arthur - University of South FloridaNitin Goyal - Baylor College of MedicinePeter Kan - Baylor College of MedicineEdward Duckworth - Baylor College of MedicineErol Veznedaroglu - Capital HealthMandy J Binning - Baylor College of MedicineKenneth M Liebman - Baylor College of MedicineVikas Rao - University of South FloridaRaymond D Turner, 4thAquilla S Turk - Capital HealthBlaise W Baxter - University of South FloridaGuilherme Dabus - Baylor College of MedicineItalo Linfante - Capital HealthKenneth V Snyder - University at Buffalo, State University of New YorkElad I Levy - University at Buffalo, State University of New YorkAdnan H Siddiqui - University at Buffalo, State University of New York
- Publication Details
- Stroke (1970), v 47(3), pp 782-788
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology; Neurosurgery
- Web of Science ID
- WOS:000371496200022
- Scopus ID
- 2-s2.0-84959561466
- Other Identifier
- 991021918104404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Peripheral Vascular Disease