Journal article
Outcomes of Mechanical Thrombectomy of Acute Basilar Artery Occlusion Due to Underlying Intracranial Atherosclerotic Disease
Stroke: vascular and interventional neurology, v 3(2), 000429
01 Mar 2023
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND: Intracranial atherosclerotic disease (ICAD) is a common cause of posterior circulation acute ischemic stroke. We aimed to compare baseline characteristics, recanalization rates, and clinical outcomes in patients with acute basilar occlusion due to underlying ICAD to patients with other causes of occlusion.
METHODS: The Trevo Registry (ClinicalTrials.gov Identifier: NCT02040259) was a prospective open-label mechanical thrombectomy registry that included 2008 patients from 76 sites across 12 countries. For a secondary analysis, we selected patients with isolated acute basilar occlusion. We then classified patients into 2 groups: patients with acute basilar artery occlusion due to ICAD (ICAD group) and patients with acute basilar occlusion due to another cause (non-ICAD group).
RESULTS: We identified 90 subjects with acute basilar occlusion. According to stroke mechanism, there were 9 (10.0%) patients in the ICAD group and 81 (90.0%) in the non-ICAD group. There was a significant difference (P=0.001) in the lesion location between the 2 groups, with 60.5% of non-ICAD occlusions located in the distal region and no ICAD occlusions there. The 2 groups showed a significant difference (P=0.003) for rescue therapy with balloon angioplasty, with 33.3% in the ICAD group and 1.2% in the non-ICAD group, respectively. In a multivariable model adjusted for age, baseline National Institutes of Health Stroke Scale, and intravenous tissue-type plasminogen activator (tPA), the odds of 90-day death (odds ratio=4.6; P=0.10) were higher for atherosclerotic subjects.
CONCLUSION: Acute basilar occlusions related to ICAD showed a similar good clinical outcome (modified Rankin scale (mRS) 0-2) and a tendency for a higher rate of 90-day mortality compared with non-ICAD occlusions.
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Details
- Title
- Outcomes of Mechanical Thrombectomy of Acute Basilar Artery Occlusion Due to Underlying Intracranial Atherosclerotic Disease
- Creators
- Bruno Bartolini - University of LausanneAntonin Krajina - University Hospital Hradec KrálovéRon Budzik - Riverside Radiol, Dept Neuroradiol, Columbus, OH USARishi Gupta - WellStar Health SystemRaul G. Nogueira - Emory UniversityAli Malek - St. Mary's Medical CenterAmrou Sarraj - The University of Texas Health Science Center at HoustonJoey English - California Pacific Medical CenterAna Paula Narata - Université de ToursMuhammad Taqi - Desert Regional Medical CenterTimothy Miller - University of Maryland, BaltimoreThomas Grobelny - Advocate Health CareBlaise Baxter - Lehigh Valley Health NetworkPaul Jenkins - Stryker (United States)David S. Liebeskind - UCLA, Dept Neurol, Los Angeles, CA USAErol Veznedaroglu - Neurosciences InstituteTrevo Registry Investigators
- Publication Details
- Stroke: vascular and interventional neurology, v 3(2), 000429
- Publisher
- Wiley
- Number of pages
- 7
- Grant note
- Stryker Neurovascular
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurosurgery
- Web of Science ID
- WOS:001151798300005
- Other Identifier
- 991021962291304721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Clinical Neurology
- Peripheral Vascular Disease