Study Demonstrates Favorable Outcomes for Endovascular Treatment of Patients with Isolated Posterior Cerebral Artery Occlusion

According to research published in Stroke, patients with isolated posterior cerebral artery (PCA) occlusion treated with endovascular therapy (EVT) achieved better improvements in National Institutes of Health Stroke Scale (NIHSS) scores and vision recovery than patients treated by medical management (MM). Although there was no difference in the 90-day modified Rankin Scale (mRS) scores between groups (aOR, 1.13 [95% CI, 0.85–1.50]; P = .41), compared with MM, EVT was associated with higher odds of a decrease in NIHSS scores by ≥ 2 points (aOR, 1.84 [95% CI, 1.35–2.52]; P = .0001) and complete vision recovery.

The retrospective cohort PLATO study (NCT05291637) included data from 1023 patients with isolated PCA occlusion from 27 sites across North America and Europe. The following inclusion criteria were utilized: a patient diagnosed with ischemic stroke attributable to an isolated PCA occlusion of the P1, P2, P3, or P4, fetal, or bilateral PCA segments of the artery; patient presentation within 24 hours of symptom onset; the patient underwent EVT or MM with or without intravenous thrombolysis IVT; and prestroke mRS score 0 to 3.

Higher risks of severe intracranial hemorrhage (sICH) and mortality were observed in the EVT group compared with the MM group, an important consideration when examining EVT as a treatment option. Study limitations include possible selection bias due to patient selection at the treating physician’s discretion and possible reporting bias due to inclusion of patients derived from clinical practice and unblinded outcomes. Consequently, this study does not translate to generalizable treatment recommendations.

The results of this study demonstrate the efficacy of EVT as a treatment option and highlight the need for ongoing randomized trials comparing EVT with MM treatment for patients with isolated PCA occlusion.