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Updated: Feb 13, 2026

Induction of Ischemic Stroke and Ischemia-reperfusion in Mice Using the Middle Artery Occlusion Technique and Visualization of Infarct Area
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Induction of Ischemic Stroke and Ischemia-reperfusion in Mice Using the Middle Artery Occlusion Technique and Visualization of Infarct Area

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Impact of stroke mechanism in acute basilar occlusion with reperfusion therapy

Woo-Jin Lee1, Keun-Hwa Jung1,2, Young Jin Ryu3

  • 1Department of Neurology Seoul National University Hospital Seoul South Korea.

Annals of Clinical and Translational Neurology
|March 22, 2018
PubMed

Insights

The mechanism of basilar artery occlusion significantly impacts outcomes after endovascular therapy (EVT). Identifying the stroke mechanism, such as in situ atherosclerotic thrombosis (ISAT) versus embolism, is crucial for predicting patient recovery and tailoring treatment strategies in acute basilar artery occlusion.

Area of Science:

  • Neurology
  • Interventional Neuroradiology
  • Vascular Neurology

Background:

  • Basilar artery (BA) occlusion is a severe condition requiring prompt treatment.
  • Endovascular therapy (EVT) is a key treatment for acute BA occlusion.
  • The underlying cause of BA occlusion may influence treatment outcomes.

Purpose of the Study:

  • To evaluate how the mechanism of BA occlusion affects outcomes after EVT.
  • To identify specific outcome predictors for each occlusion mechanism.
  • To find radiologic markers that help distinguish between occlusion mechanisms.

Main Methods:

  • Analysis of a registry database of 194 patients with acute BA occlusion undergoing EVT.
  • Classification of stroke mechanisms into in situ atherosclerotic thrombosis (ISAT) and embolism.
  • Assessment of pre-angiography MRI clot sign location, angiography, EVT parameters, and reperfusion.

Main Results:

  • The ISAT mechanism was significantly associated with poorer outcomes compared to embolism (P=0.002).
  • Outcome predictors varied: reperfusion, NIHSS scores, and onset-to-treatment time in embolism; collateral status and NIHSS scores in ISAT.
  • A distal clot sign on pre-angiography MRI strongly predicted an embolism mechanism (P<0.001).

Conclusions:

  • Stroke mechanism significantly influences outcomes in acute BA occlusion treated with EVT.
  • Predictors of outcome differ based on whether the occlusion is due to ISAT or embolism.
  • Pre-angiography MRI clot sign patterns may aid in determining the underlying BA occlusion mechanism.
Abstract

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