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Vasc Endovascular Surg. 2013 Aug;47(6):429-37. doi: 10.1177/1538574413488458. Epub 2013 May 19.

Comparison of endovascular treatment versus conservative medical treatment in patients with acute basilar artery occlusion.

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  • 1Department of Neuroradiology, Paracelsus Medical University, Christian Doppler Clinic, Salzburg, Austria. e.broussalis@salk.at

Abstract

INTRODUCTION:

Basilar artery occlusion (BAO) causes mortality up to 90%.

METHODS:

A total of 99 patients with BAO received either endovascular (endovascular mechanical recanalization and/or intra-arterial with optional intravenous thrombolysis [IVT] as bridging concept) or conservative medical treatment (IVT and/or medical oral therapy). Outcome parameters were measured in accordance with the thrombolysis in cerebral infarction (TICI), National Institutes of Health Stroke Scale (NIHSS), and modified Rankin Scale (mRS) scores.

RESULTS:

In all, 78% underwent endovascular and 22% conservative medical treatment. The NIHSS at admission was 20 in both the groups. Postprocedurally, 36% (95% confidence interval: 26%-48%) of the endovascular group and 9% (21%-64%) of the conservative group reached TICI 3 (P = .017). In all, 30% of the endovascular group and 9% of the conservative group were documented with TICI 2b (P = .057). At 90 days follow-up, 45% (31%-60%) of the endovascular-treated patientsand no patient (0%-25%) of the conservative-treated group reached mRS ≤2 (P = .012).

CONCLUSION:

Endovascular treatment of BAO provides a better chance to survive this severe condition with good clinical outcome.

KEYWORDS:

BAO; basilar artery occlusion; endovascular treatment; stroke; thrombectomy

[PubMed - indexed for MEDLINE]
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