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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.



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


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.


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).


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


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

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