Introduction
: Acute isolated posterior cerebral artery (aPCA) occlusions account for 5–10% of all ischemic strokes. Due to peculiar patient presentation, the potential benefit of mechanical thrombectomy (MT) for these patients remains controversial. Our objective is to evaluate the safety, feasibility and effectiveness of MT in these patients and compare it to literature.
Methods
: For this retrospective single‐center study, charts were reviewed for consecutive patients diagnosed with aPCA stroke who underwent MT from January 2013 thru July 2020. Presenting symptoms, patient demographics, procedural information, and 90‐day follow‐up details were noted. For the literature review, a systematic search of Pubmed, MEDLINE, and EMBASE databases was conducted for the keywords “posterior cerebral artery” and “thrombectomy” for articles published between January 2010 thru June 2021. Estimated rates for rate of recanalization, favorable outcomes (mRS 0–2), symptomatic intracerebral hemorrhage (sICH), and mortality were extracted.
Results
: Twenty‐one patients were included in the study. Mean age was 71.2 years (SD ±10.2). Median NIHSS score at presentation was 9 (IQR 5–15) with visual symptoms reported in 12 cases (57.1%). Overall, final mTICI 2b‐3 was achieved in 17 patients (80.9%) with first‐pass mTICI 2b‐3 attained in 8 (38.1%). Post‐procedure sICH occurred in 1 patients (4.7%). Fifteen patients (71.4%) had an mRS of 0–2 at 90‐days and visual symptoms resolved in 83.3%. Mortality occurred in 2 patients (9.5%). For the systematic review, 4 articles plus our cohort were included in the final analysis, totalizing 222 patients. The estimated rate of successful recanalization was 85.25% (95% CI, 73.05%‐97.45%), sICH was 3.60% (95% CI, 1.11%‐6.09%), and mortality was 10.51% (95% CI, 5.88%‐15.15%).
Conclusions
: Our results indicate MT as a potentially safe and efficacious treatment modality for aPCA strokes. Our results, in addition to the systematic review, indicate that patient selection and assessment may be the key in obtaining favorable long‐term clinical outcomes.