Thrombectomy in basilar artery occlusion.

Area of Science:

• Neurology
• Interventional Cardiology
• Vascular Surgery

Background:

• The efficacy of thrombectomy (TE) for acute ischemic stroke (AIS) due to basilar artery occlusion (BAO) remains uncertain.
• Comparison with anterior circulation large vessel occlusion (ACLVO) is needed to clarify treatment benefits.

Purpose of the Study:

• To analyze and compare 3-month functional outcomes in patients with BAO versus ACLVO undergoing TE for AIS.
• To identify factors influencing outcomes in BAO patients.

Main Methods:

• Analysis of patients from the Austrian Endostroke Registry (2013-2018).
• Propensity score matching used to compare BAO and ACLVO cohorts.
• Primary outcome: favorable functional outcome (modified Rankin Scale [mRS] 0-2) at 90 days.

Main Results:

• 264 BAO patients were matched with 264 ACLVO patients; baseline characteristics were balanced.
• No significant difference in 90-day mortality or overall functional outcome between BAO and ACLVO groups.
• Late arrival (onset-to-door time ≥270 min) in BAO patients was associated with significantly poorer functional outcomes (mRS 3-6) compared to ACLVO.

Conclusions:

• Overall functional outcomes after TE for BAO are comparable to ACLVO.
• Thrombectomy for BAO in patients with late presentation is associated with poor functional outcomes.