LAUSR

BACKGROUND AND AIMS The purpose of this study was to evaluate the safety and effectiveness of mechanical thrombectomy (MT) in patients with acute ischemic stroke (AIS) related to isolated and primary posterior cerebral artery (PCA) occlusions among the patients enrolled in the multicentre post-market Trevo Registry. METHOD Among the 2008 patients enrolled in the Trevo Registry with AIS due to large vessel occlusion (LVO) treated by MT, 22 (1.1%) (10 females [45.5%], mean age: 66.2±14.3 years [range 28-91]) had a PCA occlusion (17 P1 [77.3%] and five P2 occlusions [22.7%]). Recanalization after the first Trevo (Stryker, Fremont, CA) pass and at the end of the procedure was rated using the mTICI score. Procedure-related complications (i.e.: groin puncture complication, perforation, symptomatic hemorrhage, embolus in a new territory) were also recorded. Modified Rakin Scale (mRS) at 90 days was assessed. RESULTS Median NIHSS at admission was 14 [IQR, 8-16]. Stroke etiology was cardio-embolic in 68.2% of cases. Half of the patients (11/22) received IV tPA. 54.5% of the patients were treated under general anesthesia. Reperfusion (i.e.: mTICI2b or 3) after first pass was obtained in 65% of cases. Final TICI2b-3 reperfusion was obtained in all cases. Only one (4.5%) procedure-related complication was recorded (puncture site), that resolved after surgery. At 90-day follow-up, mRS 0-2 was obtained in 59% of the patients and 9.1% died within the first 3 months after MT. CONCLUSION Mechanical thrombectomy for PCA occlusions seem to be safe (< 5% procedure-related complications) and effective. Larger repository datasets are needed.