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Published on: July 21, 2013
Outcome in patients with basilar artery occlusion treated conventionally
W J Schonewille1, A Algra, J Serena
1University Medical Centre Utrecht, Department of Neurology, HP G 03.228, PO Box 85500, 3508 GA Utrecht, Netherlands. w.j.schonewille@neuro.azu.nl
Insights
Conventional treatment for basilar artery occlusion yields poor outcomes, with 40% mortality and 65% of survivors dependent. This highlights the need for improved treatment strategies for this condition.
Area of Science:
- Neurology
- Vascular Neurology
- Stroke Medicine
Background:
- Limited data exists on outcomes following conventional treatment for basilar artery occlusion.
- Existing data primarily comes from small, highly selected patient series undergoing intra-arterial thrombolysis.
Purpose of the Study:
- To augment the understanding of outcomes associated with conventional treatment for basilar artery occlusion.
- To provide a larger dataset on the efficacy of non-thrombolytic therapies.
Main Methods:
- Retrospective analysis of 82 patients with symptomatic basilar artery occlusion across three centers.
- Conventional therapy included antiplatelets, anticoagulation, or a combination of both.
Main Results:
- A high case fatality rate of 40% was observed.
- Among survivors, 65% experienced significant disability (Rankin score 4-5).
- Younger patients (<60 years) and those with minor strokes had better outcomes (Rankin score 0-3).
Conclusions:
- Conventional treatment for basilar artery occlusion is linked to poor functional outcomes in nearly 80% of patients.
- The findings underscore the urgent need to develop more effective therapeutic interventions.
Background:
Most data on the outcome of basilar artery occlusion are from recent case series of patients treated with intra-arterial thrombolysis. The limited knowledge on the outcome after a conventional treatment approach comes from a few small case series of highly selected patients.
Objective:
To provide more data on the outcome of conventional treatment.
Methods:
Data were analysed on patients from three centres with symptomatic basilar artery occlusion treated conventionally. Conventional therapy was defined as treatment with antiplatelets, anticoagulation, or both.
Results:
Data were available on 82 patients. The case fatality was 40%. Among survivors, 65% remained dependent (Rankin score 4-5). Patients younger than 60 years (odds ratio = 3.1 (95% confidence interval, 1.0 to 9.5)) and those with a minor stroke (OR = 3.1 (1.0 to 9.6)) were more likely to have a good outcome (Rankin score 0-3). Patients with a progressive stroke were less likely to have a good outcome (OR = 0.3 (0.08 to 1.2)) than patients with a maximum deficit at onset or fluctuating symptoms at presentation.
Conclusions:
Conventional treatment of symptomatic basilar artery occlusion is associated with a poor outcome in almost 80% of patients, which emphasises the importance of the search for a more effective treatment approach.
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