Clinical Scorecard: Comparative Analysis of Endovascular Treatment and Conventional Medical Management for Vertebrobasilar Artery Occlusion: A Systematic Review and Meta-Analysis

At a Glance

Key Highlights

• EVT significantly increases the likelihood of favorable functional outcomes (mRS 0–3).
• EVT is associated with lower 90-day all-cause mortality.
• Increased risk of symptomatic intracranial hemorrhage with EVT.
• Subgroup analyses indicate EVT benefits patients with NIHSS ≥10 and PC-ASPECTS <8.
• Treatment benefits are not significant in elderly patients and those with mild deficits.

Guideline-Based Recommendations

Diagnosis

• Assess acute vertebrobasilar artery occlusion using clinical evaluation and imaging.

Management

• Consider endovascular therapy for eligible patients with acute VBAO.

Monitoring & Follow-up

• Monitor for symptomatic intracranial hemorrhage and functional outcomes at 90 days.

Risks

• Be aware of the increased risk of symptomatic intracranial hemorrhage associated with EVT.

Patient & Prescribing Data

Adults with acute VBAO, particularly those with higher NIHSS scores.

Endovascular therapy is a cornerstone treatment, especially in patients with significant neurological deficits.

Clinical Best Practices

• Utilize advanced imaging for patient selection in EVT.
• Integrate findings from both RCTs and real-world evidence for clinical decision-making.
• Adhere to national and institutional guidelines for standard medical treatment.

References

• Systematic Review Registration