Posterior cerebraL ArTery Occlusion Study
Purpose
For this retrospective study, the investigators will collect and analyze data of patients who presented with posterior artery occlusion and underwent mechanical thrombectomy (the type of endovascular stroke treatment) and intravenous thrombolysis (the type of non-endovascular stroke treatment). The electronic health records will be queried for the demographic, medical history, and outcomes data of all patients with posterior cerebral artery occlusion who underwent mechanical thrombectomy, intravenous thrombolysis (IVT), or medical management.
Condition
- Stroke, Acute Ischemic
Eligibility
- Eligible Ages
- Between 18 Years and 89 Years
- Eligible Genders
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- Had an ischemic stroke with isolated posterior cerebral artery occlusion (P1, P2, or P3 segments) and was medically managed or managed with EVT during the study time period.
Exclusion Criteria
- Patient with documented basilar artery occlusion and concomitant PCA occlusion - Patient with documented basilar artery occlusion, migration with secondary PCA occlusion
Study Design
- Phase
- Study Type
- Observational
- Observational Model
- Cohort
- Time Perspective
- Retrospective
Arm Groups
| Arm | Description | Assigned Intervention |
|---|---|---|
| Medical management cohort | Patients who have undergone medical management stroke treatment from 1/01/2003 to 01/01/2022; this could include intravenous thrombolysis. | |
| EVT management cohort | Patients who have undergone EVT stroke treatment from 01/01/2015 to 01/01/2022 |
More Details
- Status
- Completed
- Sponsor
- Boston Medical Center
Study Contact
Detailed Description
The primary aims of the research are to evaluate, in patients presenting with posterior artery occlusion (PCA), whether favorable outcome would be superior for EVT compared to Medically Management (MM), inclusive of intravenous thrombolysis (IVT), as measured by: - 90-day modified Rankin Scale (mRS) ordinal shift or - decrease in NIH Stroke Scale/Score (NIHSS) by two points at 24 hours or at hospital discharge The secondary aims are to evaluate in patients presenting with PCA occlusion, other outcome and safety metrics: - 90-day functional independence, mRS 0-2 - 90-day excellent outcome, mRS 0-1 - Visual field recovery (none, partial, complete) by 90-days - rate of reperfusion by modified thrombolysis in cerebral infarction (TICI) scale grade - any intracranial hemorrhage - symptomatic intracranial hemorrhage - mortality In subgroup analysis, the investigators aim to identify subgroups that may confer differential treatment benefit by: - location of occlusion on the PCA segment (P1, P2, P3) - NIHSS strata (0-6, 7-15,>16) - time from symptom onset to treatment (0 to <6h vs 6-24h) - posterior circulation (PC) Acute Stroke Prognosis Early Computed Tomography Score (ASPECTS) - visual field defect on presentation The investigators hypothesize that greater benefit in outcomes would be seen in EVT treated patients with higher NIHSS, more proximal PCA occlusion, higher PC ASPECTS scores, and shorter time from symptom onset to treatment.