Thrombectomy in Posterior Circulation Tandem Occlusions: Multicenter Comparative Analysis of Procedural Techniques and Predictors of Clinical Outcomes.
Publication/Presentation Date
6-1-2026
Abstract
Background Evidence on thrombectomy outcomes for posterior circulation tandem occlusions (TOs) is mostly from small single-center series. Purpose To evaluate thrombectomy outcomes in posterior circulation TOs. Materials and Methods Data from consecutive patients from 15 North American centers (February 2016 to October 2023) who underwent thrombectomy for posterior circulation TOs-defined as intracranial vertebral artery, basilar artery, or posterior cerebral artery occlusion with concurrent proximal extra- or intracranial vertebral artery stenosis or occlusion-were retrospectively analyzed. Baseline clinical, imaging, and procedural variables were summarized. Primary and clinical outcomes included successful reperfusion (modified Thrombolysis in Cerebral Infarction [mTICI] score ≥ 2b), safety outcomes (symptomatic intracranial hemorrhage [sICH] and procedure-related complications), and 90-day functional outcome (modified Rankin Scale [mRS] score). Univariable and multivariable logistic regression was used to identify factors associated with favorable outcomes. Results Among 123 patients (median age, 63 years [IQR, 55-72 years]; 77 male patients), median National Institutes of Health Stroke Scale (NIHSS) score was 17 (IQR, 9-28). Intravenous thrombolytics were administered in 37 of 123 (30.1%) patients, and 97 of 123 (78.9%) underwent general anesthesia. Combined stent retriever and aspiration was the most common distal thrombectomy technique (45 of 123 [36.6%]), then aspiration (40 of 123 [32.5%]). Rescue stenting was required in 48 of 123 (39.0%) patients, more for proximal than distal lesions (44 of 123 [35.8%] vs nine of 123 [7.3%];
Volume
319
Issue
3
First Page
252830
Last Page
252830
ISSN
1527-1315
Published In/Presented At
Salem, M. M., Helal, A., Sioutas, G., Gajjar, A. A., Mohammaden, M. H., El Naamani, K., Kuhn, A. L., Monteiro, A., Tschoe, C., Cortez, G., Tarek, M. A., Dmytriw, A. A., Regenhardt, R., Marioni, S. S., AbdalKader, M., Nguyen, T. N., Tjoumakaris, S. I., Puri, A. S., Pereira, V. M., Rabinov, J. D., … Burkhardt, J. K. (2026). Thrombectomy in Posterior Circulation Tandem Occlusions: Multicenter Comparative Analysis of Procedural Techniques and Predictors of Clinical Outcomes. Radiology, 319(3), e252830. https://doi.org/10.1148/radiol.252830
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
42334349
Department(s)
Administration and Leadership
Document Type
Article