Acute Treatment of Isolated Posterior Cerebral Artery Occlusion: Single Center Experience

Cunha, Bruno; Baptista, Mariana; Pamplona, Jaime; Carvalho, Rui A.; Câmara, Catarina Perry da; Alves, Marta; Papoila, Ana Luísa; Nunes, Ana Paiva; Reis, João Carlos R.; Fragata, Isabel

doi:10.1016/j.jstrokecerebrovasdis.2021.106239

Cited by 13 publications

(38 citation statements)

References 21 publications

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“…Twelve studies were included in the analysis [5, 12–16, 18, 19, 21, 25, 26, 29]. The search strategy is shown in Figure S1.…”

Section: Resultsmentioning

confidence: 99%

“…In addition, EVT is increasingly used to treat patients with isolated occlusions of the PCA. Several recent studies demonstrated the feasibility and safety of EVT in these patients [5,[12][13][14][15][16][17][18][19][20][21]. However, randomized clinical trials demonstrating the efficacy of EVT in the treatment of isolated PCA occlusions are lacking.…”

Section: Although Clinical Symptoms Of Pca Infarcts May Results In a Lowmentioning

confidence: 99%

“…Secondary safety outcomes included symptomatic intracranial hemorrhage (sICH) and mortality at 3 months. sICH was defined according to the European Cooperative Acute Stroke Study (ECASS) II or III criteria in most of the studies [5, 13, 15, 16, 19, 23–26]; the studies by Herweh et al and Brouwer et al used the Heidelberg bleeding classification for definition of sICH [12, 21, 27]. Information extracted from each study included sample size, age, sex, percentage of patients receiving IVT, NIHSS score at admission, time from onset of symptoms to acute treatment (IVT or puncture), rate of successful reperfusion, rate of sICH, clinical outcomes and mortality at 3 months.…”

Section: Methodsmentioning

confidence: 99%

“…distal vessel occlusion, endovascular therapy, intravenous thrombolysis, posterior cerebral artery occlusion, stroke the studies [5,13,15,16,19,[23][24][25][26]; the studies by Herweh et tional outcome was used in the study (mRS of 0-1 instead of 0-2) [16]. We obtained supplemental data for the analysis of good clinical outcome by Strambo et al, who also used a different definition of favorable functional outcome in their publication [5].…”

Section: Introductionmentioning

confidence: 99%

“…the studies [5,13,15,16,19,[23][24][25][26]; the studies by Herweh et al and Brouwer et al used the Heidelberg bleeding classification for definition of sICH [12,21,27]. Information extracted from each study included sample size, age, sex, percentage of patients receiving IVT, NIHSS score at admission, time from onset of symptoms to acute treatment (IVT or puncture), rate of successful reperfusion, rate of sICH, clinical outcomes and mortality at 3 months.…”

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confidence: 99%

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Endovascular therapy versus no endovascular therapy in patients receiving best medical management for acute isolated occlusion of the posterior cerebral artery: A systematic review and meta‐analysis

Berberich

Finitsis

Strambo

et al. 2022

Euro J of Neurology

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Background and purpose Endovascular therapy (EVT) is increasingly reported for treatment of isolated posterior cerebral artery (PCA) occlusions although its clinical benefit remains uncertain. This study‐level meta‐analysis investigated the functional outcomes and safety of EVT and best medical management (BMM) compared to BMM alone for treatment of PCA occlusion stroke. Methods We conducted a literature search in PubMed, Web of Science and Embase for studies in patients with isolated PCA occlusion stroke treated with EVT + BMM or BMM including intravenous thrombolysis. There were no randomized trials and all studies were retrospective. The primary outcome was modified Rankin Scale score of 0–2 at 3 months, while safety outcomes included mortality rate and incidence of symptomatic intracranial hemorrhage (sICH). Results Twelve studies with a total of 679 patients were included in the meta‐analysis: 338 patients with EVT + BMM and 341 patients receiving BMM alone. Good functional outcome at 3 months was achieved in 58.0% (95% confidence interval [CI] 43.83–70.95) of patients receiving EVT + BMM and 48.1% (95% CI 40.35–55.92) of patients who received BMM alone, with respective mortality rates of 12.6% (95% CI 7.30–20.93) and 12.3% (95% CI 8.64–17.33). sICH occurred in 4.2% (95% CI 2.47–7.03) of patients treated with EVT + BMM and 3.2% (95% CI 1.75–5.92) of patients treated with BMM alone. Comparative analyses were performed on studies that included both treatments and these demonstrated no significant differences. Conclusions Our results demonstrate that EVT represents a safe treatment for patients with isolated PCA occlusion stroke. There were no differences in clinical or safety outcomes between treatments, supporting randomization of future patients into distal vessel occlusion trials.

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“…Twelve studies were included in the analysis [5, 12–16, 18, 19, 21, 25, 26, 29]. The search strategy is shown in Figure S1.…”

Section: Resultsmentioning

confidence: 99%

Section: Although Clinical Symptoms Of Pca Infarcts May Results In a Lowmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Endovascular therapy versus no endovascular therapy in patients receiving best medical management for acute isolated occlusion of the posterior cerebral artery: A systematic review and meta‐analysis

Berberich

Finitsis

Strambo

et al. 2022

Euro J of Neurology

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Endovascular Therapy in Acute Isolated Posterior Cerebral Artery Occlusion

et al. 2022

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Purpose Patients with isolated posterior cerebral artery occlusion (iPCAO) represent up to 6% of all acute ischemic stroke patients. Acute revascularization therapies for these patients were not tested in randomized controlled trials. The aim of this study was to evaluate outcomes of iPCAO patients who undergo endovascular treatment (EVT). Methods A systematic search of MEDLINE, Web of Science, CENTRAL, Scopus (inception—03/2022) was conducted for studies reporting 3‑month outcome, symptomatic intracranial hemorrhage (sICH) and/or successful recanalization in iPCAO patients who underwent EVT. Random effect meta-analyses for pooled proportions were calculated. Double-arm meta-analyses for comparison of outcomes of iPCAO patients treated with EVT with age-, sex- and NIHSS-matched iPCAO patients treated with best medical treatment only were performed. Results Fifteen studies reporting a total of 461 iPCAO patients who underwent EVT were included. Excellent and favorable 3‑month outcome proportions were 36% (95% confidence interval, CI 20–51%) and 57% (95% CI 40–73%), respectively. The 3‑month mortality was 9% (95% CI 5–13), sICH occurred in 1% (95% CI 0–2%), successful recanalization was achieved in 79% (95% CI 71–86%). No significant differences in favorable and excellent 3‑month outcomes, 3‑month mortality and symptomatic intracerebral hemorrhage were found between the groups of patients who underwent EVT and the group of patients who received best medical treatment only. Conclusion These results support the feasibility and safety of EVT in iPCAO, but do not show an outcome benefit with EVT compared to best medical treatment. Randomized trials are needed to evaluate treatment benefit of EVT in these patients.

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Endovascular thrombectomy for treatment of isolated posterior cerebral artery occlusion: a real-world analysis of hospitalizations in the United States

Dicpinigaitis,

Syed,

Al-Mufti

et al. 2024

Acta Neurochir

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Acute Treatment of Isolated Posterior Cerebral Artery Occlusion: Single Center Experience

Cited by 13 publications

References 21 publications

Endovascular therapy versus no endovascular therapy in patients receiving best medical management for acute isolated occlusion of the posterior cerebral artery: A systematic review and meta‐analysis

Endovascular therapy versus no endovascular therapy in patients receiving best medical management for acute isolated occlusion of the posterior cerebral artery: A systematic review and meta‐analysis

Endovascular Therapy in Acute Isolated Posterior Cerebral Artery Occlusion

Endovascular thrombectomy for treatment of isolated posterior cerebral artery occlusion: a real-world analysis of hospitalizations in the United States

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