Endovascular treatment for distal basilar artery occlusion stroke

Jiaxing Song; Zhou Yu; Jian Wang; Xiaojun Luo; Jie Du; Zhengxuan Tian; Shunyu Yang; Weihua Xie; Yuqi Peng; Jinlin Mu; Wenjie Zi; Shuchun Huang; Mei Yang

doi:10.3389/fneur.2022.931507

Endovascular treatment for distal basilar artery occlusion stroke

Front Neurol. 2022 Aug 9:13:931507. doi: 10.3389/fneur.2022.931507. eCollection 2022.

Authors

Jiaxing Song¹, Zhou Yu², Jian Wang³, Xiaojun Luo⁴, Jie Du⁵, Zhengxuan Tian⁶, Shunyu Yang⁷, Weihua Xie⁸, Yuqi Peng⁹, Jinlin Mu¹⁰, Wenjie Zi¹, Shuchun Huang¹¹, Mei Yang¹²

Affiliations

¹ Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
² Department of Neurology, The First People's Hospital of Liangshan Yi Autonomous Prefecture, Sichuan, China.
³ Department of Neurology, Ya'an People's Hospital, Sichuan, China.
⁴ Department of Cerebrovascular Diseases, Guangyuan Central Hospital, Sichuan, China.
⁵ Department of Neurology, Kaizhou District People's Hospital, Sichuan, China.
⁶ Department of Neurology, The 404th Hospital of Mianyang, Sichuan, China.
⁷ Department of Neurology, The First People's Hospital of Yunnan, Yunnan, China.
⁸ Department of Neurology, People's Hospital of Mengzi, Yunnan, China.
⁹ Department of Neurology, Sichuan Science City Hospital, Sichuan, China.
¹⁰ Department of Neurology, Nanjiang County Traditional Chinese Medicine Hospital, Sichuan, China.
¹¹ Department of Neurology, Hospital 302 Attached to Guizhou Aviation Group, Guizhou, China.
¹² Department of Neurology, Dali Bai Autonomous Prefecture People's Hospital, Yunnan, China.

Abstract

Background: This study aimed to investigate the clinical outcomes of endovascular treatment (EVT) for distal basilar artery occlusion (BAO) and compare them with the outcomes of standard medical treatment (SMT) in daily clinical practice.

Methods: Patients with distal BAO enrolled in the BASILAR study from January 2014 to May 2019 were included. Differences in clinical outcomes were analyzed using Pearson's chi-square test and multivariable logistic regression. Clinical outcomes were evaluated using the modified Rankin Scale (mRS) score at 90 days, the mortality at 90 days, and the occurrence of symptomatic intracranial hemorrhage within 48 h.

Results: Among the 267 patients with distal BAO (222 patients in the EVT group and 45 patients in the SMT group), compared with the SMT group, the EVT group was associated with a favorable outcome (mRS 0-3; 40.1 vs. 15.6%; aOR 5.44; 95% CI, 1.68-17.66; P = 0.005) and decreased mortality (44.6 vs. 71.1%, aOR 0.32, 95% CI, 0.13-0.77; P = 0.012). In the EVT group, multivariable analysis showed that the initial National Institutes of Health Stroke Scale (NIHSS) score and posterior circulation-Alberta Stroke Program Early CT Score (pc-ASPECTS) were associated with favorable functional outcomes and mortality.

Conclusion: Our study suggests that, compared with SMT, EVT is technically feasible and safe for patients with distal BAO.

Keywords: acute basilar artery occlusion; distal basilar artery occlusion; endovascular treatment (EVT); occlusion site; stroke.