Thrombectomy for Posterior Circulation Stroke: Predictors of Outcomes in a Brazilian Registry

Pazuello, Guilherme Borghini; Castro-Afonso, Luís Henrique de; Fornazari, Vitor Rodrigues; Nakiri, Guilherme Seizem; Abud, Thiago Giansante; Monsignore, Lucas Moretti; Dias, F.T.; Martins-Filho, Rui Kleber; Camilo, Millene Rodrigues; Aléssio-Alves, Frederico Fernandes; Pontes-Neto, Octávio Marques; Abud, Daniel Giansante

doi:10.1016/j.wneu.2020.12.060

Cited by 8 publications

(20 citation statements)

References 38 publications

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“…luo et al (8) observed a mortality rate of 24.6% at 90 days. Similar studies observed mortality rates ranging from 21-33% at 90 days (5,22,30,31). the present study observed a mortality rate of 23.53% and the causes of death were intraoperative procedural complications.…”

Section: Discussionsupporting

confidence: 86%

“…luo et al (8) indicated that the collateral status prior to Mt, as well as the baseline NIHSS score were independent predictors of mortality at 90 days in patients with acute posterior circulation stroke who underwent Solitaire aB thrombectomy. Studies have demonstrated that the reperfusion time is one of the key predictors of a good prognosis of patients with anterior circulation, as well as posterior circulation stroke (5,(12)(13)(14)41). Nevertheless, other studies have not found any link between the reperfusion time and good prognosis of patients with posterior circulation strokes (5,19,42,43).…”

Section: Discussionmentioning

confidence: 99%

“…Studies have demonstrated that the reperfusion time is one of the key predictors of a good prognosis of patients with anterior circulation, as well as posterior circulation stroke (5,(12)(13)(14)41). Nevertheless, other studies have not found any link between the reperfusion time and good prognosis of patients with posterior circulation strokes (5,19,42,43). Baik et al (18) observed a poor outcome despite the good recanalization rate, which may have been due to the longer procedural time.…”

Section: Discussionmentioning

confidence: 99%

“…acute ischemic stroke (aIS) is one of the primary triggers of disability, as well as mortality worldwide with a substantial burden on health systems and families (1)(2)(3). aIS of the posterior circulation as a result of vertebrobasilar artery occlusions (VBaos) constitutes 10-20% of all large vessel occlusions (lVos) with a mortality rate of almost 90% and most frequently affecting the basilar artery (Ba) (4)(5)(6)(7)(8). the posterior circulation mainly provides blood supply to the main parts of the brain, such as the brainstem, thalamus and cerebellum (9).…”

Section: Introductionmentioning

confidence: 99%

“…Intravenous tissue plasminogen activator (t-Pa) administered within 4.5 h of the stroke is currently the recommend treatment for patients with thrombolytic ischemic strokes (10,11). of note, mechanical thrombectomy (Mt) for the treatment of acute thrombolytic ischemic stroke has exhibited favorable outcomes in both anterior and posterior lVos (5,(12)(13)(14)(15)(16)(17). almost all studies involving acute VBao have focused primarily on prognostic factors, such as the severity of neurologic deficits, the time of onset to treatment, the location of the occlusion, the state of collaterals, treatment or management options, as well as timely reperfusion (18)(19)(20)(21).…”

Section: Introductionmentioning

confidence: 99%

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Mechanical thrombectomy for vertebral and basilar artery occlusions: An institutional experience with 17 patients

Richard²,

et al. 2022

Med Int

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acute ischemic stroke of the posterior circulation as a result of vertebrobasilar artery occlusions is often associated with severe morbidity and mortality rates. Vertebrobasilar artery occlusion retrieval via mechanical thrombectomy (Mt) is a novel treatment modality for occlusive strokes. Nevertheless, factors associated with positive outcomes have not yet been adequately investigated. thus, the present study focused on factors associated with good prognosis following this type of treatment. the present study retrospectively analyzed a series of 17 patients with acute vertebral artery occlusions (Vaos) and basilar artery occlusions (Baos) treated with Mt. In all patients, information such as sex and age, time from admission to the onset of femoral artery access, the number of thrombi removed, the time of femoral artery access to recanalization, pre-and post-operative National Institutes of Health Stroke Scale (NIHSS) scores, pre-and post-operative thrombolysis in cerebral infarction, as well as modified Rankin scale scores were documented and analyzed. the analysis comprised of 11 patients with Baos and 6 patients with Vaos. a recanalization rate of 70.6% was achieved with an overall good functional outcome of 58.8% at 90 days. observationally, there was a notable improvement in outcomes when comparing the NIHSS prior to surgery with NIHSS at 1 week after the surgery. a lower NIHSS score prior to Mt may be a good prognostic factor. an average time of ~5.5 h from patient admittance to recanalization with a 70.6% recanalization rate with an overall good functional outcome of 58.8% at 90 days suggested that, patients for whom the surgeries were performed within 5 h of admittance may still have hope for recanalization compared to an initial 1.5-h average time for recanalization.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Mechanical thrombectomy for vertebral and basilar artery occlusions: An institutional experience with 17 patients

Richard²,

et al. 2022

Med Int

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Effectiveness and safety of mechanical thrombectomy for acute ischaemic stroke in Latin American countries: A systematic review

González-Aquines¹,

Cordero-Pérez²,

Mohammadnezhad³

et al. 2023

Journal of Stroke and Cerebrovascular Diseases

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

Borończyk,

Kuźniak,

Borończyk

et al. 2024

Sci Rep

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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.

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Thrombectomy for Posterior Circulation Stroke: Predictors of Outcomes in a Brazilian Registry

Cited by 8 publications

References 38 publications

Mechanical thrombectomy for vertebral and basilar artery occlusions: An institutional experience with 17 patients

Mechanical thrombectomy for vertebral and basilar artery occlusions: An institutional experience with 17 patients

Effectiveness and safety of mechanical thrombectomy for acute ischaemic stroke in Latin American countries: A systematic review

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

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