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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
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In basilar-artery occlusion stroke, thrombectomy improved functional outcomes without increasing ICH
1Eastern Virginia Medical School/Sentara Norfolk General Hospital, Norfolk, Virginia, USA (B.L.).
Annals of Internal Medicine
|February 6, 2023
Summary
Endovascular thrombectomy is effective for treating stroke caused by basilar artery occlusion up to 24 hours after symptom onset. This treatment significantly improves functional outcomes for patients with acute ischemic stroke.
Area of Science:
- Neurology
- Interventional Neurology
- Vascular Neurology
Background:
- Basilar artery occlusion (BAO) is a severe form of ischemic stroke with high rates of death and disability.
- The optimal time window for endovascular thrombectomy in BAO remains debated, particularly beyond 6 hours.
Purpose of the Study:
- To evaluate the efficacy and safety of endovascular thrombectomy in patients with acute ischemic stroke due to BAO between 6 and 24 hours after symptom onset.
Main Methods:
- A randomized clinical trial comparing thrombectomy with medical management.
- Patients were randomized if they had confirmed BAO and were eligible for thrombectomy within the extended time window.
- Outcomes were assessed using the modified Rankin Scale (mRS) at 90 days.
Main Results:
- Thrombectomy group showed a significantly higher rate of functional independence (mRS score 0-3) compared to the control group (44.6% vs. 28.5%).
- The procedure was associated with a favorable safety profile, with no significant difference in symptomatic intracranial hemorrhage.
Conclusions:
- Endovascular thrombectomy is a safe and effective treatment for carefully selected patients with BAO up to 24 hours after symptom onset.
- This extends the therapeutic window for mechanical reperfusion in posterior circulation stroke.
