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KMID : 1142120220240020207
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Journal of Stroke
2022 Volume.24 No. 2 p.207 ~ p.223
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Endovascular Treatment for Posterior Circulation Stroke: Ways to Maximize Therapeutic Efficacy
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Lee Seong-Joon
Hong Ji-Man
Kim Jong-S.
Lee Jin-Soo
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Abstract
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The efficacy of endovascular treatment (EVT) in patients with posterior circulation stroke has not been proven. Two recent randomized controlled trials failed to show improved functional outcomes after EVT for posterior circulation stroke (PC-EVT). However, promising results for two additional randomized controlled trials have also been presented at a recent conference. Studies have shown that patients undergoing PC-EVT had a higher rate of futile recanalization than those undergoing EVT for anterior circulation stroke. These findings call for further identification of prognostic factors beyond recanalization. The significance of baseline clinical severity, infarct volume, collaterals, time metrics, core-penumbra mismatch, and methods to accurately measure these parameters are discussed. Furthermore, their interplay on EVT outcomes and the potential to individualize patient selection for PC-EVT are reviewed. We also discuss technical considerations for improving the treatment efficacy of PC-EVT.
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KEYWORD
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Cerebral infarction, Posterior circulation, Endovascular treatment, Mechanical thrombectomy, Basilar artery occlusion, Vertebrobasilar artery occlusion
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