Endovascular Thrombectomy With and Without Preceding Thrombolysis in Posterior Circulation Stroke-Insights From STAR.

Publication/Presentation Date

9-1-2024

Abstract

BACKGROUND: Multiple randomized trials could not establish the noninferiority of endovascular thrombectomy (EVT) alone without preceding intravenous thrombolysis (IVT) or superiority of IVT followed by EVT in anterior circulation large-vessel occlusion stroke. The role of prior IVT in posterior circulation large-vessel occlusion remains controversial.

METHODS: In this multicenter, retrospective study, patients with stroke with large-vessel occlusion in the posterior circulation who received EVT alone or with IVT were selected from the stroke thrombectomy and aneurysm registry between 2013 and 2022. Effects of IVT followed by thrombectomy on favorable functional outcome (defined as modified Rankin scale≤3 at 90 days) and safety were investigated using multivariable logistic and linear regression models.

RESULTS: Of the 588 included patients, 67% (n = 394) were treated with EVT alone and 29% (n = 170) with EVT after IVT, and 4% (n = 24) have missing values on this variable. Controlling for multiple confounding factors, IVT was not associated with a higher likelihood of favorable functional outcome at 90 days (odds ratio, 1.04 [95% CI, 0.52-2.09;

CONCLUSION: Similar functional outcomes and complication rates were seen in patients with posterior circulation large-vessel occlusion treated with EVT alone versus EVT after IVT. Further prospective studies are required to determine the utility of IVT in posterior circulation stroke, especially in patients being directly admitted to thrombectomy centers.

Volume

4

Issue

5

First Page

001334

Last Page

001334

ISSN

2694-5746

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

41586281

Department(s)

Administration and Leadership

Document Type

Article

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