Open AccessEndovascular Thrombectomy for Acute Basilar Artery Occlusion: A Multicenter Retrospective Observational Study
Author(s) -
Kang DongHun,
Jung Cheolkyu,
Yoon Woong,
Kim Seul Kee,
Baek Byung Hyun,
Kim JoonTae,
Park Man Seok,
Kim Yong Won,
Hwang Yang Ha,
Kim YongSun,
Kim Beom Joon,
Han MoonKu,
Bae HeeJoon
Publication year - 2018
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.118.009419
Subject(s) - medicine , modified rankin scale , stroke (engine) , retrospective cohort study , hematoma , surgery , clopidogrel , logistic regression , diabetes mellitus , aspirin , ischemic stroke , ischemia , mechanical engineering , engineering , endocrinology
Background Despite the recent acceptance of thrombectomy as the standard of care in patients with acute anterior circulation stroke, the benefits of thrombectomy remain uncertain for patients with acute basilar artery occlusion ( BAO ). This study aimed to evaluate the effectiveness and safety of thrombectomy and to identify predictors of outcomes in a large cohort of patients with acute BAO . Methods and Results This study included 212 consecutive patients with acute BAO who underwent either stent‐retriever or contact aspiration thrombectomy as the first‐line approach between January 2011 and August 2017 at 3 stroke centers. Clinical and radiologic data were prospectively collected and stored in a database at each center. Multivariable ordinal logistic regression was performed to assess the association between each characteristic and 90‐day modified Rankin scale scores. Reperfusion was successful in 91.5% (194/212) of patients; 44.8% (95/212) of patients achieved 90‐day modified Rankin scale 0 to 2. The symptomatic hemorrhage rate was 1.9% (4/212) and mortality was 16% (34/212). In a multivariable ordinal regression, younger age, lower National Institute of Health stroke scale on admission, and absence of diabetes mellitus and parenchymal hematoma were significantly associated with a favorable shift in the overall distribution of 90‐day modified Rankin scale scores. Treatment outcomes were similar between patients who received stent‐retriever thrombectomy and contact aspiration thrombectomy as the first‐line technique. Conclusions Endovascular thrombectomy was effective and safe for treating patients with acute BAO . Age, the baseline National Institute of Health stroke scale, diabetes mellitus, and parenchymal hematoma were associated with better outcomes. This study showed no superiority of the stent‐retriever over the aspiration thrombectomy for treating acute BAO .