Examining The Effects Of Intra-Arterial Therapy In Acute Posterior Circulation Occlusions

Background: Recent trials have failed to show benefit of intra-arterial therapy (IAT) in acute ischemic stroke (AIS) patients. Patients with posterior circulation occlusions, however, were vastly underrepresented (only 4 patients in IMS3, MR-RESCUE and SYNTHESIS combined). IAT is often pursued, due to the inherent poor outcome associated with brainstem infarction. We sought to evaluate potential benefit with IAT in this population. Methods: A US multicenter retrospective cohort of 106 patients with AIS and LAO in the vertebrobasilar distribution presenting 01/05-3/14 within 12 hours from stroke onset was examined. Patients were divided into two groups (IAT vs No IAT). Logistic regression with good and poor (discharge mRS 0-2 and 4-6) outcome was performed. Univariate and multivariate analyses evaluated independent predictors of good outcome after IAT. Results: Patients in the IAT group (n=57) had more severe strokes (NIHSS 24 vs 12) than the medical management group (n=49); otherwise the two groups were c...