Abstract Background and aims Although mechanical thrombectomy (MT) is a recognized treatment for anterior circulation strokes, its effectiveness in posterior circulation large vascular occlusion (LVO) is still uncertain. We aimed to assess mechanical thrombectomy outcomes in hyperacute posterior circulation strokes resulting from large vessel occlusion, while finding significant prognostic markers. Methods This prospective cohort research comprised patients who received MT due to an acute ischemic stroke resulting from LVO in the posterior circulation. Patients were eligible if they had an NIHSS score of 6 or higher, a pc-ASPECTS score of 6 or higher, and a pre-stroke mRS ranging from 0 to 1. Results A total of 16 individuals with AIS of LVO origin who received MT within 24 hours were included. 68.7% of patients had complete recanalization (mTICI = 2b-3), while 31.3% had partial recanalization (mTICI = 2a). The median NIHSS score improved to less than 6 in 56.25% of patients after 24 hours. At three months, 81.2% of patients had an excellent functional result (mRS ≤2). On the other hand, 18.8% experienced a bad outcome (mRS 2). The unfavorable group had higher NIHSS ratings, longer door-to-puncture times, and later clinical manifestation. On the other hand, the favorable group was linked to successful reperfusion (mTICI 2b-3) and better collateral circulation (SIR 3-4). Conclusions MT improved functional outcomes in posterior circulation stroke, highlighting the importance of effective reperfusion and better collateral circulation as potential excellent predictors and highlighting the negative prognostic markers of increased stroke severity, delayed presentation, and prolonged door-to-puncture time. Conflict of interest Hamada Salama, Mostafa Meshref, Mahmoud Galal and Mahmoud Abdelmoety had nothing to disclose.
Salama et al. (2026) studied this question.