Endovascular Versus Medical Management of Posterior Cerebral Artery Occlusion Stroke: The PLATO Study-Reference-Cited by-同舟云学术

Endovascular Versus Medical Management of Posterior Cerebral Artery Occlusion Stroke: The PLATO Study

Published:2023-07 Issue:7 Volume:54 Page:1708-1717
ISSN:0039-2499
Container-title:Stroke
language:en
Short-container-title:Stroke

Author:

Nguyen Thanh N.¹²,Qureshi Muhammad M.²³^ORCID,Strambo Davide⁴^ORCID,Strbian Daniel⁵^ORCID,Räty Silja⁵^ORCID,Herweh Christian⁶,Abdalkader Mohamad²^ORCID,Olive-Gadea Marta⁷,Ribo Marc⁷^ORCID,Psychogios Marios⁸,Fischer Urs⁹¹⁰^ORCID,Nguyen Anh⁸^ORCID,Kuramatsu Joji B.¹¹^ORCID,Haupenthal David¹¹^ORCID,Köhrmann Martin¹²,Deuschl Cornelius¹³^ORCID,Kühne Escola Jordi¹²,Yaghi Shadi¹⁴^ORCID,Shu Liqi¹⁴^ORCID,Puetz Volker¹⁵^ORCID,Kaiser Daniel P.O.¹⁶^ORCID,Kaesmacher Johannes¹⁷^ORCID,Mujanovic Adnan¹⁸^ORCID,Marterstock Dominique Cornelius¹⁹^ORCID,Engelhorn Tobias¹⁹^ORCID,Klein Piers²^ORCID,Haussen Diogo C.¹⁸^ORCID,Mohammaden Mahmoud H.¹⁸^ORCID,Abdelhamid Hend¹⁸^ORCID,Souza Viana Lorena¹⁸^ORCID,Cunha Bruno²⁰^ORCID,Fragata Isabel²⁰^ORCID,Romoli Michele²¹^ORCID,Diana Francesco²²^ORCID,Virtanen Pekka²³²⁴^ORCID,Lappalainen Kimmo²³²⁴,Clark Judith¹^ORCID,Matsoukas Stavros²⁵^ORCID,Fifi Johanna T.²⁵^ORCID,Sheth Sunil A.²⁶^ORCID,Salazar-Marioni Sergio²⁶^ORCID,Marto João Pedro²⁷^ORCID,Ramos João Nuno²⁸^ORCID,Miszczuk Milena²⁹^ORCID,Riegler Christoph³⁰^ORCID,Jadhav Ashutosh P.³¹^ORCID,Desai Shashvat M.³¹^ORCID,Maus Volker³²,Kaeder Maximilian³²^ORCID,Siddiqui Adnan H.³³^ORCID,Monteiro Andre³³,Masoud Hesham E.³⁴^ORCID,Suryadevara Neil³⁵,Mokin Maxim³⁶^ORCID,Thanki Shail³⁶^ORCID,Siegler James E.³⁷^ORCID,Khalife Jane³⁷^ORCID,Linfante Italo³⁸^ORCID,Dabus Guilherme³⁸^ORCID,Asdaghi Negar³⁹^ORCID,Saini Vasu³⁹^ORCID,Nolte Christian H.³⁰,Siebert Eberhard²⁹^ORCID,Meinel Thomas R.¹⁰,Finitsis Stefanos⁴⁰,Möhlenbruch Markus A.⁶,Ringleb Peter A.⁴¹,Berberich Anne⁴²^ORCID,Nogueira Raul G.³⁵^ORCID,Hanning Uta⁴³^ORCID,Meyer Lukas⁴³^ORCID,Michel Patrik⁴^ORCID,Nagel Simon⁴¹⁴²^ORCID

Affiliation:

1. Neurology (T.N.N., J.C.), Boston Medical Center, MA.

2. Radiology (T.N.N., M.M.Q., M.A., P.K.), Boston Medical Center, MA.

3. Radiation Oncology (M.M.Q.), Boston Medical Center, MA.

4. Neurology Service, Lausanne University Hospital, University of Lausanne, Switzerland (D. Strambo, P.M.).

5. Neurology (D. Strbian, S.R.), Helsinki University Hospital, Finland.

6. Neuroradiology (C.H., M. Moehlenbruch), Heidelberg University Hospital, Germany.

7. Neurology (M.O.-G., M. Ribo), Hospital Universitario Vall d’Hebron, Barcelona, Spain.

8. Radiology, (A.N, M.P.), Basel University Hospital, University of Basel, Switzerland.

9. Neurology (U.F.), Basel University Hospital, University of Basel, Switzerland.

10. Neurology, Bern University Hospital, University of Bern, Switzerland (T.R.M., U.F.).

11. Neurology (J.B.K., D.H.) University of Erlangen-Nuremberg, Germany.

12. Neurology (M. Köhrmann, J.K.E.), Universitätsklinikum Essen, Germany.

13. Radiology (C.D.), Universitätsklinikum Essen, Germany.

14. Neurology, Rhode Island Hospital, Brown University Medical School, Providence, RI (S.Y., L.S.).

15. Neurology (V.P.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany.

16. Neuroradiology (D.P.O.K.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany.

17. Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern Inselspital, University of Bern, Switzerland (J. Kaesmacher, A. Mujanovic).

18. Neurology, Grady Memorial Hospital, Atlanta, GA (D.C.H., M.H.M., H.A., L.S.V.).

19. Neuroradiology (D.C.M., T.E.), University of Erlangen-Nuremberg, Germany.

20. Neuroradiology, Centro Hospitalar Universitario de Lisboa Central, Portugal (B.C., I.F.).

21. Neurology and Stroke Unit, Department of Neuroscience, Bufalini Hospital, Cesena, Italy (M. Romoli).

22. Interventional Neuroradiology (F.D.), Hospital Universitario Vall d’Hebron, Barcelona, Spain.

23. Radiology (P.V., K.L.), Helsinki University Hospital, Finland.

24. Radiology, Helsinki University Hospital, University of Helsinki, Finland (P.V., K.L.).

25. Neurosurgery, Mount Sinai Health System, New York City, NY (S.M., J.T.F.).

26. Neurology, McGovern Medical School at UTHealth, TX (S.A.S., S.S.-M.).

27. Neurology (J.P.M.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal.

28. Neuroradiology (J.N.R.), Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal.

29. Neuroradiology (M. Miszczuk, E.S.), Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité–Universitätsmedizin Berlin, Germany.

30. Neurology, Experimental Neurology (C.R., C.H.N.), Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité–Universitätsmedizin Berlin, Germany.

31. Neurosurgery, Barrow Neurological Institute, Phoenix, AZ (A.P.J., S.M.D.).

32. Radiology, Neuroradiology and Nuclear Medicine, University Hospital Knappschaftskrankenhaus Bochum, Germany (V.M., M. Kaeder).

33. Neurosurgery, University of Buffalo, NY (A.H.S., A. Monteiro).

34. Neurology, New York Upstate Medical University, Syracuse, NY (H.E.M.).

35. Neurology, University of Pittsburgh Medical Center, PA (R.G.N., N.S.).

36. Neurosurgery, University of South Florida, Tampa (M. Mokin, S.T.).

37. Cooper Neurological Institute, Camden, NJ (J.E.S., J. Khalife).

38. Miami Neuroscience Institute, FL (I.L., G.D.).

39. Neurology, University of Miami Miller School of Medicine, FL (N.A., V.S.).

40. Radiology, Aristotle University of Thessaloniki, Greece (S.F.).

41. Neurology (P.A.R., S.N.), Heidelberg University Hospital, Germany.

42. Neurology, Klinikum Ludwigshafen, Germany (A.B., S.N.).

43. Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Germany (U.H., L.M.).

Abstract

BACKGROUND: The optimal management of patients with isolated posterior cerebral artery occlusion is uncertain. We compared clinical outcomes for endovascular therapy (EVT) versus medical management (MM) in patients with isolated posterior cerebral artery occlusion. METHODS: This multinational case-control study conducted at 27 sites in Europe and North America included consecutive patients with isolated posterior cerebral artery occlusion presenting within 24 hours of time last well from January 2015 to August 2022. Patients treated with EVT or MM were compared with multivariable logistic regression and inverse probability of treatment weighting. The coprimary outcomes were the 90-day modified Rankin Scale ordinal shift and ≥2-point decrease in the National Institutes of Health Stroke Scale. RESULTS: Of 1023 patients, 589 (57.6%) were male with median (interquartile range) age of 74 (64–82) years. The median (interquartile range) National Institutes of Health Stroke Scale was 6 (3–10). The occlusion segments were P1 (41.2%), P2 (49.2%), and P3 (7.1%). Overall, intravenous thrombolysis was administered in 43% and EVT in 37%. There was no difference between the EVT and MM groups in the 90-day modified Rankin Scale shift (aOR, 1.13 [95% CI, 0.85–1.50]; P =0.41). There were higher odds of a decrease in the National Institutes of Health Stroke Scale by ≥2 points with EVT (aOR, 1.84 [95% CI, 1.35–2.52]; P =0.0001). Compared with MM, EVT was associated with a higher likelihood of excellent outcome (aOR, 1.50 [95% CI, 1.07–2.09]; P =0.018), complete vision recovery, and similar rates of functional independence (modified Rankin Scale score, 0–2), despite a higher rate of SICH and mortality (symptomatic intracranial hemorrhage, 6.2% versus 1.7%; P =0.0001; mortality, 10.1% versus 5.0%; P =0.002). CONCLUSIONS: In patients with isolated posterior cerebral artery occlusion, EVT was associated with similar odds of disability by ordinal modified Rankin Scale, higher odds of early National Institutes of Health stroke scale improvement, and complete vision recovery compared with MM. There was a higher likelihood of excellent outcome in the EVT group despite a higher rate of symptomatic intracranial hemorrhage and mortality. Continued enrollment into ongoing distal vessel occlusion randomized trials is warranted.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)

Reference15 articles.

1. Incidence of Acute Ischemic Stroke With Visible Arterial Occlusion

2. Long-term outcome in posterior cerebral artery stroke

3. Thrombectomy and Thrombolysis of Isolated Posterior Cerebral Artery Occlusion

4. Endovascular versus Medical Management of Acute Basilar Artery Occlusion: A Systematic Review and Meta-Analysis of the Randomized Controlled Trials

5. Endovascular Therapy for Basilar Artery Occlusion

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