First-line aspiration may be a more effective treatment option than stent retriever thrombectomy for posterior circulation stroke patients, according to new data published in Stroke.
“Both thrombectomy methods have proven to be safe and effective in patients with acute ischemic stroke in the anterior circulation,” wrote Marie Louise E. Bernsen, MD, a specialist at Rijnstate Hospital in the Netherlands, and colleagues. “Little is known about their efficacy in stroke caused by posterior circulation occlusion.”
The group tracked data from MR CLEAN registry related to 205 adult patients who presented with a posterior circulation stroke from March 2014 to December 2018 in the Netherlands. While 65% of patients were treated with stent retriever thrombectomy, the remaining patients were treated with aspiration. General anesthesia was more commonly needed for patients in the aspiration group.
Overall, the group found, first-line aspiration was linked to improved functional outcomes and procedure times that were approximately 20 minutes shorter. Also, the rate of successful reperfusion was higher for patients in the aspiration group than the stent retriever thrombectomy group (87% vs. 73%).
Symptomatic hemorrhage rates, however, were similar between the two groups. There was also no significant difference in patient mortality.
“More research in the form of randomized trials is necessary to confirm our findings and to assess if aspiration thrombectomy leads to better clinical outcome compared with intravenous thrombolysis alone,” the authors wrote.
The full analysis is available here.
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