Endovascular treatment in the posterior circulation stroke: A retrospective study

Abstract

Background & Objective: Posterior circulation stroke accounts for approximately 20% of all ischemic strokes and is a serious neurological event affecting a different areas of the brain. Although endovascular treatment is the gold standard for stroke in the anterior circulation system, there is no consensus on the best treatment in the posterior circulation system. We aimed to demonstrate the effectiveness and safety of the procedure in posterior circulation system stroke.

Methods: Patients older than 18 years of age who had been diagnosed with a stroke in the posterior circulation system are included. Symptom duration, Alberta Stroke Program Early Computed Tomography scores in the posterior system, occlusion level, arrival Glascow Coma Scores (GCS), admission National Institute of Health Stroke Scale scores, 90-day mortality, modified treatment score for cerebral infarction and 3rd month modified Rankin Scores (mRS) were examined retrospectively.

Results: The study population included 29 patients. Average procedure duration and average symptom duration was calculated as 61.72±49.09 and 235.90±153.13 minutes respectively. Average GCS score was found to be 8.86±4.27. Most of the occlusions were distal basilar (51.7%). Revascularization was achieved in 82.8% (n=24) of the cases. Favourable outcome (mRS ≤3 ) was achieved in 41.3% of the cases. Three cases of symptomatic haemorrhage occured after the treatment.

Conclusion: Although the success of the procedure in the posterior circulation system is relatively high, the desired good functional outcome rates still remain low. Ensuring rapid diagnosis of patients and shortening the duration of symptoms will positively affect the prognosis.