Clin Ter. 2026 Jan-Feb;177(1):114-122. doi: 10.7417/CT.2026.1982.
ABSTRACT
BACKGROUND: The efficacy and safety of endovascular treatment (EVT) for acute ischemic stroke (AIS) due to large-vessel occlusion (LVO) in the posterior circulation remain controversial. This study aimed to provide further evidence on the safety and effectiveness of EVT through a prospective comparative cohort design.
MATERIALS & METHODS: This prospective, descriptive study included 131 patients with AIS due to vertebrobasilar LVO admitted within 24 hours of symptom onset, from December 2023 to November 2024. Patients were allocated to either the EVT group (n = 70) or the best medical treatment group (n = 61). Functional outcome at 90 days was assessed using the modified Rankin Scale (mRS), along with mortality and rates of symptomatic hemorrhagic transformation.
RESULTS: Favorable outcomes (mRS 0-3 at 90 days) were significantly more frequent in the EVT group compared to the non-EVT group (25.8% vs. 9.9%, p = 0.019). The 90-day mortality rate was significantly lower in the EVT group (22.8% vs. 66.8%, p = 0.001). However, the rate of symptomatic intracranial hemorrhage was higher in the EVT group (p = 0.001). The absence of hypertension and a time from admission to femoral artery puncture of ≤120 minutes were identified as independent predictors of favorable functional outcome at 90 days after the intervention.
CONCLUSIONS: Endovascular treatment in AIS due to vertebrobasilar LVO is associated with better functional outcomes and lower mortality but carries an increased risk of hemorrhagic complications. These findings support the potential benefit of EVT in posterior circulation strokes, warranting further validation in larger studies.
PMID:41525121 | DOI:10.7417/CT.2026.1982