Endovascular Stroke Therapy for Posterior Circulation Acute Ischemic Stroke Has Diminishing Benefit with Additional Passes

• DOI: 10.1161/svin.122.000663
• Publication Date: 2023-02-25T11:58:55Z
• Authors: Jerome A. Jeevarajan; Hyun‐Woo Kim; Muhammad Bilal Tariq; Sergio Salazar Ma...; Arash Niktabe; Rania Abdelkhaleq; Louise McCullough; Sunil A. Sheth
• Keywords: Interquartile range; Stroke; Posterior cerebral artery

Background The relationship between pass number during endovascular stroke therapy (EST) and outcomes in anterior circulation large vessel occlusion (LVO) acute ischemic (AIS) has been well studied. However, the association EST attempts for patients with posterior LVO remains unclear. Methods From our prospectively maintained multicenter registry, we identified consecutive AIS who underwent EST. of thrombectomy passes per‐pass reperfusion grades (thrombolysis cerebral infarction) were recorded at time procedure. primary outcome was functional independence (modified Rankin scale 0–2) 90 days. Secondary included likelihood attaining substantial infarction 2b‐3). Results Among 894 EST, median age 68 [interquartile range 58–78], 49% female, National Institutes Health Stroke Scale 16 11–21]. Of this cohort, 86 (9.6%) had LVO, including 65 (7%) basilar artery 9 (1%) vertebral occlusion. diminishing benefit on successful additional similar AIS. stroke, fewer associated greater good days (40.0% versus 4.8% modified 0–2 1–2 3+ passes; P = 0.003). treated comparable to 40.2%, anterior; 0.553). Conclusions a significant After 2 passes, there is significantly reduced conferred by passes. Overall clinical compared LVO.