PMID- 31669246
OWN - NLM
STAT- MEDLINE
DCOM- 20200305
LR  - 20200305
IS  - 1878-8769 (Electronic)
IS  - 1878-8750 (Linking)
VI  - 134
DP  - 2020 Feb
TI  - Mechanical Thrombectomy for Basilar Artery Occlusion Compared with Anterior 
      Circulation Stroke.
PG  - e469-e475
LID - S1878-8750(19)32716-0 [pii]
LID - 10.1016/j.wneu.2019.10.097 [doi]
AB  - OBJECTIVE: To investigate the clinical effectiveness of mechanical thrombectomy 
      (MT) for basilar artery occlusion (BAO) and to ascertain whether outcomes for 
      patients with BAO were comparable to those with anterior circulation large vessel 
      occlusion (ACS). METHODS: A total of 345 patients who underwent MT between 2011 
      and 2018 were grouped by occlusion site (295 patients with ACS and 50 patients 
      with BAO). Patients' baseline characteristics, procedural times, complications, 
      symptomatic intracranial hemorrhage, modified Rankin Scale score, and mortality 
      at 90 days were analyzed. RESULTS: Male preponderance (66.0% vs. 48.8%; P = 
      0.0316), younger age (72.5 years [interquartile range (IQR), 64.75-78.5 years] 
      vs. 77 years [IQR 69-84 years]; P = 0.0297), higher National Institutes of Health 
      Stroke Scale score (24.5 [IQR, 13-32] vs. 18 [IQR 13-22]; P = 0.0015) and higher 
      reperfusion rate (100% vs. 84.7%; P = 0.0010) were observed in patients with BAO. 
      We found no significant difference in favorable outcomes (modified Rankin Scale 
      score </=2) between patients with BAO and patients with ACS (64.3% vs. 49.3%; P = 
      0.0914). In multivariate analysis, Alberta Stroke Program Early Computed 
      Tomography Score (odds ratio [OR], 1.282; 95% confidence interval [CI], 
      1.090-1.524; P = 0.0024), time from onset to reperfusion (OTR) (OR, 0.9950; 95% 
      CI, 0.992-0.998; P = 0.0008), successful reperfusion (OR, 6.953; 95% CI, 
      1.576-48.729; P = 0.0092), and hemorrhagic complication (OR, 0.352; 95% CI, 
      0.151-0.797; P = 0.0122) were associated with a favorable outcome at 90 days in 
      patients with ACS. In patients with BAO, only OTR (OR, 0.9879; 95% CI, 
      0.974-0.999; P = 0.0314) was associated with a favorable outcome at 90 days. 
      CONCLUSIONS: MT may be considered the standard care for patients with BAO. OTR 
      was the only common significant predictor for favorable outcomes in both patient 
      cohorts.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - Uno, Junji
AU  - Uno J
AD  - Department of Neurosurgery, Baba Memorial Hospital, Osaka, Japan. Electronic 
      address: babahpns@silver.ocn.ne.jp.
FAU - Kameda, Katsuharu
AU  - Kameda K
AD  - Department of Neurosurgery, Baba Memorial Hospital, Osaka, Japan.
FAU - Otsuji, Ryosuke
AU  - Otsuji R
AD  - Department of Neurosurgery, Baba Memorial Hospital, Osaka, Japan.
FAU - Ren, Nice
AU  - Ren N
AD  - Department of Neurosurgery, Baba Memorial Hospital, Osaka, Japan.
FAU - Nagaoka, Shintaro
AU  - Nagaoka S
AD  - Department of Neurosurgery, Baba Memorial Hospital, Osaka, Japan.
FAU - Maeda, Kazushi
AU  - Maeda K
AD  - Department of Neurosurgery, Baba Memorial Hospital, Osaka, Japan.
FAU - Ikai, Yoshiaki
AU  - Ikai Y
AD  - Department of Neurosurgery, Baba Memorial Hospital, Osaka, Japan.
FAU - Gi, Hidefuku
AU  - Gi H
AD  - Department of Neurosurgery, Baba Memorial Hospital, Osaka, Japan.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
DEP - 20191024
PL  - United States
TA  - World Neurosurg
JT  - World neurosurgery
JID - 101528275
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Basilar Artery/diagnostic imaging/surgery
MH  - Endovascular Procedures/*methods
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Stroke/*diagnostic imaging/*surgery
MH  - Thrombectomy/*methods
MH  - Vertebrobasilar Insufficiency/*diagnostic imaging/*surgery
OTO - NOTNLM
OT  - Basilar artery occlusion
OT  - Cerebrovascular disease/stroke
OT  - Mechanical thrombectomy
OT  - Posterior circulation
OT  - Revascularization
OT  - Stroke
EDAT- 2019/11/02 06:00
MHDA- 2020/03/07 06:00
CRDT- 2019/11/01 06:00
PHST- 2019/08/20 00:00 [received]
PHST- 2019/10/15 00:00 [revised]
PHST- 2019/10/16 00:00 [accepted]
PHST- 2019/11/02 06:00 [pubmed]
PHST- 2020/03/07 06:00 [medline]
PHST- 2019/11/01 06:00 [entrez]
AID - S1878-8750(19)32716-0 [pii]
AID - 10.1016/j.wneu.2019.10.097 [doi]
PST - ppublish
SO  - World Neurosurg. 2020 Feb;134:e469-e475. doi: 10.1016/j.wneu.2019.10.097. Epub 
      2019 Oct 24.