Mechanical thrombectomy is a routine procedure for posterior circulation distal, medium vessel occlusion (DMVO). However, not much information on the potential benefit of the treatment is available. This study aims to investigate the frequency and clinical safety and outcomes of mechanical thrombectomy for isolated posterior circulation DMVO stroke.

 This multicenter case-control study included a total of 243 patients who were treated for primary distal occlusion of the posterior cerebral artery (PCA). A total of 184 patients matched the criteria and were randomly assigned in a 1:1 ratio to mechanical thrombectomy or standard medical treatment with or without IVT. The primary outcome of the study was the improvement of the National Institutes of Health Stroke Scale (NIHSS).

 Of the 184 patients included in the study, posterior circulation DMVOs were located in the PCA’s P2 segment in 149 patients and P3 segment in 35 patients. The mean NIHSS score at discharge decreased by –2.4 points in the standard medical treatment group, compared to –3.9 points in the mechanical thrombectomy cohort. Mechanical thrombectomy had significant treatment effects in patients with high NIHSS scores.

 The research concluded that mechanical thrombectomy for posterior circulation DMVO is a safe and feasible treatment option for occlusions of the PCA’s P2 and P3 segments.