Outcomes of Endovascular Therapy in Young Patients with Acute Basilar Artery Occlusion: A Substudy of BASILAR Registry Study.

Abstract

This study aimed to investigate clinical outcomes in young patients with basilar artery occlusion (BAO) receiving endovascular therapy (EVT). Consecutive patients with BAO within 24h who underwent EVT from the BASILAR Registry study were enrolled. We compared clinical outcomes of young patients (aged 18-55years) with older patients (aged > 55years) with stroke due to BAO at 90days and 1year after EVT. The primary and secondary outcomes were improvement in modified Rankin scale scores (mRS) at 90days and either favorable (mRS 0-3) or mortality at 90days, respectively. A total of 646 patients were included, of which 152 (23.53%) were aged 18-55years. Dyslipidemia (42.11% vs. 30.36%, p = 0.007) and good collateral circulation (60.52% vs. 46.35%, p = 0.002) were more frequent in young patients than older. Stroke etiologies in young patients included large artery atherosclerosis (67.11%), cardioembolism (15.13%), and vessel dissection (5.26%). Young patients were associated with better prognosis (mRS: adjusted odds ratio (aOR) 1.73; 95% confidence interval [CI] 1.21-2.48; mRS 0-3: aOR 1.60; 95%CI 1.01-2.54; mortality: aOR 0.60; 95%CI 0.38-0.93) at 90days. Baseline National Institutes of Health Stroke Scale (NIHSS) score, posterior circulation Alberta Stroke Program Early Computed Tomography Score (pc-ASPECTS), and sex were independent predictors of clinical outcomes of young patients at 90days after EVT. Young patients with BAO had better clinical outcomes after EVT than old patients. Predictors of clinical outcomes in young patients undergoing EVT included baseline NIHSS score, pc-ASPECTS, and sex. Clinical Trial Registration-URL: ChiCTR180001475 ( www.chictr.org.cn ).