Targeted temperature management in patients with acute basilar artery occlusion after successful recanalization

Targeted temperature management (TTM) has been reported to improve outcomes in retrospective clinical studies, especially after recanalization in patients with anterior circulation stroke. However, the efficacy of TTM in managing posterior circulation stroke remains unexplored. Therefore, we investigated the clinical effects of TTM in patients with acute basilar artery occlusion who had successful revascularization.

We enrolled patients with acute ischemic stroke due to basilar artery occlusion, with an initial National Institutes of Health Stroke Scale score of ≥ 10, who had successful recanalization (defined as thrombolysis in cerebral ischemia grade ≥ 2b). All patients underwent a TTM protocol targeting a core temperature of 36°C, supported by mechanical ventilation and at least 24 h of temperature management. Clinical outcomes were compared, including favorable outcomes at 3 months (defined as a modified Rankin Scale score of ≤3), mortality, length of intensive care unit (ICU) stay, and safety profiles.

The TTM group (n = 16) had a significantly lower rate of good clinical outcomes [2 (12.5%) vs. 12 (48.0%), p = 0.045] and a significantly longer ICU stay [11.0 (8.5-15.0) vs. 9.0 (4.0-12.0), p = 0.007] compared to the non-TTM group (n = 25). Mortality was higher in the non-TTM group, although this difference was not statistically significant. Pneumonia occurred significantly more frequently in the TTM group than in the non-TTM group (p = 0.004).

TTM may not improve clinical outcomes in patients with acute basilar artery occlusion after successful recanalization.