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SHR Neuro Cancer Cardio Lipid Metab Microb
Hendrix, P; Killer-Oberpfalzer, M; Broussalis, E; Melamed, I; Sharma, V; Mutzenbach, S; Pikija, S; Collins, M; Lieberman, N; Hecker, C; Goren, O; Zand, R; Schirmer, CM; Trinka, E; Griessenauer, CJ.
Mechanical Thrombectomy for Anterior versus Posterior Circulation Large Vessel Occlusion Stroke with Emphasis on Posterior Circulation Outcomes.
World Neurosurg. 2022; 158: e416-e422.
Doi: 10.1016/j.wneu.2021.10.187
Web of Science
PubMed
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FullText_MUG
- Co-authors Med Uni Graz
- Pikija Slaven
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- Abstract:
- PURPOSE: Although there is class I evidence for mechanical thrombectomy (MT) for anterior circulation large vessel occlusion (LVO) stroke, no high-class evidence exists for the posterior circulation. Here, we sought to compare clinical features of anterior versus posterior LVO as well as predictors of a posterior LVO MT outcome. METHODS: Patients with acute ischemic stroke who underwent MT for anterior and posterior LVO stroke between February 2016 and August 2020 from 2 comprehensive stroke centers were reviewed. Anterior and posterior LVO strokes were compared. In addition, predictors for a favorable outcome (modified Rankin scale [mRS] 0-3), death (mRS 6), and futile revascularization (mRS 4-6 despite TICI 2b/3 revascularization) for posterior LVO were analyzed. RESULTS: Collectively, 813 LVO thrombectomy cases were analyzed, and 77 of 813 cases (9.5%) were located in the posterior circulation. Although favorable 90-day functional outcome rates did not differ between anterior and posterior LVO (P = 0.093), death was significantly more frequent among posterior LVO cases (P = 0.013). In the posterior LVO subgroup, a primary aspiration technique and successful revascularization TICI 2b/3 irrespective of time to the intervention were independently associated with achieving a favorable outcome. Primary aspiration was identified to inversely associate with futile revascularization. CONCLUSION: Anterior and posterior circulation MT patients have distinct clinical profiles. The use of primary aspiration appears fundamental for beneficial outcomes in posterior circulation MT.
- Find related publications in this database (using NLM MeSH Indexing)
- Arterial Occlusive Diseases - etiology
- Brain Ischemia - etiology
- Humans - administration & dosage
- Ischemic Stroke - administration & dosage
- Retrospective Studies - administration & dosage
- Stroke - etiology
- Thrombectomy - methods
- Treatment Outcome - administration & dosage
- Find related publications in this database (Keywords)
- Mechanical thrombectomy
- Posterior circulation
- Stroke