Abstract Background and aims Data on reperfusion therapy (RT) outcomes in posterior circulation strokes (PCS) compared to anterior circulation strokes (ACS) are still inconclusive. Most trials assessed the outcomes after up to 90 days. We aimed to compare the early and the late outcomes, up to 12 months, between ACS and PCS subjects treated with RT. Methods 306 subjects were included, 101 with PSC and 205 with ACS. The primary outcome was lethal outcome (LO): during the hospitalization, after 3 and after 12 months. The secondary outcomes were NIHSS after 24 hours and 7 days, functional outcome (FU) after 3 and 12 months and complications. Good FU was defined as mRS 0-2, ambulatory FU - mRS 0-3. Results Early LO occurred less frequently in the PCS (2.0% vs 7.8%, p = 0.042). After 3 months, there were more good FU in the PCS group (64.0% vs 51.7%, p = 0.043). After 12 months, PCS group LO (18.0% vs 30.0%, p = 0.025) and median mRS (2 vs 3, p = 0.042) were significantly lower. Unadjusted odds ratio (OR) for LO in 12 months in PCS group was 0.51 (95%CI 0.28–0.92). Adjusted OR did not reach statistical significance (OR-0.51,95%CI 0.24–1.02). Conclusions Although early mortality was lower in PCS even after the adjustment for the main confounders, this trend was not retained in 3 months. There was a trend for a lower chance of lethal outcome in 12 months in PCS subjects, however, it did not reach statistical significance after the adjustment. Conflict of interest Aleksandra Ekkert: nothing to disclose. Givi Lengvenis: nothing to disclose. Dalius Jatužis: nothing to disclose.
Ekkert et al. (2026) studied this question.