Abstract
BackgroundEndovascular treatment (EVT) is now considered the gold standard for select patient populations with anterior circulation stroke; however, data on the treatment of posterior circulation stroke are less clear. This study aims to determine the characteristics and treatment outcomes of patients with acute basilar artery occlusion (BAO) and to evaluate the effectiveness and safety of EVT for patients with acute BAO in a high-volume stroke center.MethodsThis study included 187 consecutive patients with acute BAO who underwent EVT from January 2012 to July 2018 in the Beijing Tiantan Hospital. The baseline characteristics, procedure parameters, and functional outcome were assessed.ResultsAmong the 187 patients, 138 (73.8%) underwent mechanical thrombectomy with a stent retriever, 33 (17.6%) underwent direct intracranial angioplasty (balloon dilation and/or stent implantation) for underlying severe intracranial atherosclerotic disease, and 91 (48.7%) underwent combined mechanical thrombectomy and angioplasty. Successful recanalization [modified Thrombolysis in Cerebral Infarction (mTICI) grade 2b-3] was achieved in 158 patients (84.5%). Overall, the rates of functional independence [modified Rankin Scale (mRS) 0–2] and favorable outcome (mRS 0–3) at 90 days were 36.4 and 49.2%, respectively, and 90-day all-cause mortality was 20.3%.ConclusionEVT was effective and safe for treating patients with acute BAO.
Highlights
Endovascular treatment (EVT) is considered the gold standard for select patient populations with anterior circulation stroke; data on the treatment of posterior circulation stroke are less clear
We retrospectively analyzed clinical and radiologic data of these patients, including age; sex; stroke risk factors including hypertension, diabetes mellitus, hypercholesterolemia, and current smoking; initial stroke severity as expressed by the National Institutes of Health Stroke modified Thrombolysis in Cerebral Infarction (mTICI) modified Thrombolysis in Cerebral Infarction (Scale) (NIHSS) score; initial imaging modality; prior use of intravenous thrombolysis (IVT); type of EVT devices; onset to puncture time; procedure time; onset to recanalization time; collateral status; and etiology of stroke according to the Trial of Org 10,172 in Acute Stroke Treatment (TOAST) classification [10]
Our findings demonstrate that when patients were carefully selected and appropriately treated with EVT, those with posterior large vessel occlusions can achieve comparable safety and efficacy to those with anterior large vessel occlusions
Summary
Endovascular treatment (EVT) is considered the gold standard for select patient populations with anterior circulation stroke; data on the treatment of posterior circulation stroke are less clear. This study aims to determine the characteristics and treatment outcomes of patients with acute basilar artery occlusion (BAO) and to evaluate the effectiveness and safety of EVT for patients with acute BAO in a high-volume stroke center. Acute ischemic stroke (AIS) caused by basilar artery occlusion (BAO) has devastating effects on patients and has high morbidity and mortality rates. More studies embracing the New England Center Posterior Circulation Registry have shown no significant differences in the clinical features of posterior circulation stroke (PCS) compared with those with anterior circulation stroke (ACS) and a more benign outcome in patients with PCS [7, 8]. The efficacy and safety of MT in patients with acute Bao are uncertain due to the lack of case series and case reports showing the efficacy and safety of posterior circulation thrombectomy in a single-arm study. Our intention was to depict our experience with EVT for acute
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
