{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T03:42:17Z","timestamp":1788406937421,"version":"build-2803163510"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Despite the proven effectiveness of endovascular therapy (EVT) in acute ischemic strokes (AIS) involving anterior circulation large vessel occlusions, isolated posterior cerebral artery (PCA) occlusions (iPCAo) remain underexplored in clinical trials. This study investigates the comparative effectiveness and safety of EVT against medical management (MM) in patients with iPCAo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This multinational, multicenter propensity score-weighted study analyzed data from the Multicenter Analysis of primary Distal medium vessel occlusions: effect of Mechanical Thrombectomy (MAD-MT) registry, involving 37 centers across North America, Asia, and Europe. We included iPCAo patients treated with either EVT or MM. The primary outcome was the modified Rankin Scale (mRS) at 90\u2009days, with secondary outcomes including functional independence, mortality, and safety profiles such as hemorrhagic complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 177 patients were analyzed (88\u2009MM and 89 EVT). EVT showed a statistically significant improvement in 90-day mRS scores (OR\u2009=\u20090.55, 95% CI\u2009=\u20090.30\u20131.00, p\u2009=\u20090.048), functional independence (OR\u2009=\u20092.52, 95% CI\u2009=\u20091.02\u20136.20, p\u2009=\u20090.045), and a reduction in 90-day mortality (OR\u2009=\u20090.12, 95% CI\u2009=\u20090.03\u20130.54, p\u2009=\u20090.006) compared to MM. Hemorrhagic complications were not significantly different between the groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>EVT for iPCAo is associated with better neurological outcomes and lower mortality compared to MM, without an increased risk of hemorrhagic complications. Nevertheless, these results should be interpreted with caution due to the study\u2019s observational design. The findings are hypothesis-generating and highlight the need for future randomized controlled trials to confirm these observations and establish definitive treatment guidelines for this patient population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23969873241291465","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T05:35:05Z","timestamp":1729488905000},"page":"387-396","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":18,"title":["Endovascular therapy versus medical management in isolated posterior cerebral artery acute ischemic stroke: A multinational multicenter propensity score-weighted study"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5208-8425","authenticated-orcid":false,"given":"Hamza Adel","family":"Salim","sequence":"first","affiliation":[{"name":"Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA 1"},{"name":"Department of Neuroradiology, MD Anderson Medical Center, Houston, TX, USA 2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Pulli","sequence":"additional","affiliation":[{"name":"Department of Interventional Neuroradiology, Stanford Medical Center, Palo Alto, CA, USA 3"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek","family":"Yedavalli","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4910-6090","authenticated-orcid":false,"given":"Basel","family":"Musmar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, LA, USA 4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimer","family":"Adeeb","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, LA, USA 4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7577-1887","authenticated-orcid":false,"given":"Dhairya","family":"Lakhani","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8325-2382","authenticated-orcid":false,"given":"Muhammed Amir","family":"Essibayi","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA 5"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kareem","family":"El Naamani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA 6"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Henninger","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA 7"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sri Hari","family":"Sundararajan","sequence":"additional","affiliation":[{"name":"Department of Endovascular Neurosurgery and Neuroradiology, NJMS, Newark, NJ, USA 8"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Luisa","family":"K\u00fchn","sequence":"additional","affiliation":[{"name":"Division of Neurointerventional Radiology, Department of Radiology, University of Massachusetts Medical Center, Worcester, MA, USA 9"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Khalife","sequence":"additional","affiliation":[{"name":"Cooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA 10"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherief","family":"Ghozy","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery & Radiology, Mayo Clinic, Rochester, MN, USA 11"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1316-0383","authenticated-orcid":false,"given":"Luca","family":"Scarcia","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Henri Mondor Hospital, Creteil, France 12"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inayat","family":"Grewal","sequence":"additional","affiliation":[{"name":"Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA 13"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin YQ","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 14"},{"name":"Division of Neurology, Department of Medicine, National University Hospital, Singapore 15"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2958-3484","authenticated-orcid":false,"given":"Robert W","family":"Regenhardt","sequence":"additional","affiliation":[{"name":"Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA 13"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy J","family":"Heit","sequence":"additional","affiliation":[{"name":"Department of Interventional Neuroradiology, Stanford Medical Center, Palo Alto, CA, USA 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18"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8533-7478","authenticated-orcid":false,"given":"Jens","family":"Fiehler","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany 19"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil","family":"Sheth","sequence":"additional","affiliation":[{"name":"Department of Neurology, UTHealth McGovern Medical School, Houston, TX, USA 20"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajit S","family":"Puri","sequence":"additional","affiliation":[{"name":"Division of Neurointerventional Radiology, Department of Radiology, University of Massachusetts Medical Center, Worcester, MA, USA 9"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Dyzmann","sequence":"additional","affiliation":[{"name":"Neuroradiology Department, 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Sorbonne University, Paris VI, Paris, France 32"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James E","family":"Siegler","sequence":"additional","affiliation":[{"name":"Cooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA 10"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2810-1685","authenticated-orcid":false,"given":"Thanh N","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Departments of Radiology & Neurology, Boston Medical Center, Boston, MA, USA 28"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Varela","sequence":"additional","affiliation":[{"name":"Department of Neurology, Centro Hospitalar Universit\u00e1rio do Porto, Porto, Portugal 33"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Baker","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA 5"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Altschul","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA 5"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8277-6317","authenticated-orcid":false,"given":"Nestor R","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA 34"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5075-704X","authenticated-orcid":false,"given":"Markus A","family":"M\u00f6hlenbruch","sequence":"additional","affiliation":[{"name":"Sektion Vaskul\u00e4re und Interventionelle Neuroradiologie, Universit\u00e4tsklinikum Heidelberg, Heidelberg, Germany 35"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Costalat","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France 27"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Gory","sequence":"additional","affiliation":[{"name":"Department of Interventional Neuroradiology, Nancy University Hospital, Nancy, France 36"},{"name":"INSERM U1254, IADI, Universit\u00e9 de Lorraine, Vandoeuvre-les-Nancy, France 37"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian Paul","family":"Stracke","sequence":"additional","affiliation":[{"name":"Department of Radiology, Interventional Neuroradiology Section, University Medical Center M\u00fcnster, M\u00fcnster, Germany 38"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Ali","family":"Aziz-Sultan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston MA, USA 17"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantin","family":"Hecker","sequence":"additional","affiliation":[{"name":"Departments of Neurology & Neurosurgery, Christian Doppler Clinic, Paracelsus Medical University Salzburg, Salzburg, Austria 39"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamza","family":"Shaikh","sequence":"additional","affiliation":[{"name":"Cooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA 10"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph J","family":"Griessenauer","sequence":"additional","affiliation":[{"name":"Departments of Neurology & Neurosurgery, Christian Doppler Clinic, Paracelsus Medical University Salzburg, Salzburg, Austria 39"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5109-8736","authenticated-orcid":false,"given":"David S","family":"Liebeskind","sequence":"additional","affiliation":[{"name":"UCLA Stroke Center and Department of Neurology Department, UCLA, Los Angeles, CA, USA 40"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Pedicelli","sequence":"additional","affiliation":[{"name":"UOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A. 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