Outcome of Mechanical Thrombectomy for Acute Basilar Artery Occlusion in Patients with Intracranial Atherosclerotic...

Area of Science:

• Neurology
• Vascular Neurology
• Interventional Neurology

Background:

• Intracranial atherosclerotic disease (ICAD) is a significant cause of acute basilar artery occlusion (BAO).
• Understanding the characteristics and outcomes of BAO patients with and without ICAD is crucial for optimizing treatment strategies.

Purpose of the Study:

• To compare the clinical characteristics and endovascular treatment outcomes of acute BAO patients with and without ICAD.
• To identify factors associated with ICAD in BAO patients.

Main Methods:

• Prospective cohort study of 208 acute BAO patients undergoing endovascular treatment within 24 hours.
• Comparison of baseline characteristics and 90-day outcomes between ICAD and non-ICAD groups.
• Multivariable logistic regression analysis to determine factors associated with ICAD.

Main Results:

• ICAD was present in 53.8% of BAO patients.
• Proximal basilar artery occlusion was more frequent in the ICAD group (55.4% vs. 21.9%), while distal occlusion was more common in the non-ICAD group (58.3% vs. 10.7%).
• ICAD patients had longer onset-to-treatment times (11.6 vs. 9.5 hours) and higher rates of rescue stenting (15.2% vs. 0%). Dyslipidemia was associated with ICAD (aOR 2.44).
• No significant differences were observed in good functional outcome (45.5% vs. 44.8%), symptomatic hemorrhage (4.5% vs. 8.3%), or mortality (42% vs. 50%) between groups.

Conclusions:

• ICAD is a frequent cause of BAO, often associated with proximal occlusions and dyslipidemia.
• Despite differing characteristics and treatment nuances, ICAD did not significantly affect 90-day functional outcomes, hemorrhage rates, or mortality in BAO patients treated with endovascular therapy.