Comparison of Endovascular Treatment Versus Conservative Medical Treatment in Patients With Acute Basilar Artery Occlusion

作者：Erasmia Broussalis, Wolfgang Hitzl, Mark R. McCoy, Eugen Trinka, M. Killer · 发表于：Vascular and Endovascular Surgery · 年份：2013 · DOI：10.1177/1538574413488458 · 被引用次数：24 · 研究领域：Acute Ischemic Stroke Management、Cerebrovascular and Carotid Artery Diseases、Peripheral Artery Disease Management

INTRODUCTION: Basilar artery occlusion (BAO) causes mortality up to 90%. METHODS: A total of 99 patients with BAO received either endovascular (endovascular mechanical recanalization and/or intra-arterial with optional intravenous thrombolysis [IVT] as bridging concept) or conservative medical treatment (IVT and/or medical oral therapy). Outcome parameters were measured in accordance with the thrombolysis in cerebral infarction (TICI), National Institutes of Health Stroke Scale (NIHSS), and modified Rankin Scale (mRS) scores. RESULTS: In all, 78% underwent endovascular and 22% conservative medical treatment. The NIHSS at admission was 20 in both the groups. Postprocedurally, 36% (95% confidence interval: 26%-48%) of the endovascular group and 9% (21%-64%) of the conservative group reached TICI 3 (P = .017). In all, 30% of the endovascular group and 9% of the conservative group were documented with TICI 2b (P = .057). At 90 days follow-up, 45% (31%-60%) of the endovascular-treated patientsand no patient (0%-25%) of the conservative-treated group reached mRS ≤2 (P = .012). CONCLUSION: Endovascular treatment of BAO provides a better chance to survive this severe condition with good clinical outcome.