Current Opinions on Optimal Management of Basilar Artery Occlusion: After the BEST of BASICS Survey

作者：Brian Drumm, Soma Banerjee, Muhammad M. Qureshi, Wouter J. Schonewille, Piers Klein, Xiaochuan Huo, Yimin Chen, Daniel Strbian, Urs Fischer, Volker Puetz, Wei Hu, Xunming Ji, Chuanhui Li, Fana Alemseged, Hiroshi Yamagami, Simona Sacco, Gustavo Saposnik, Patrik Michel, Espen Saxhaug Kristoffersen, Petra Šedová, Robert Mikulík, James E. Siegler, Thomas R. Meinel, Diana Aguiar de Sousa, Kyriakos Lobotesis, Dylan Roi, Jelle Demeestere, Kaiz Asif, Sheila Cristina Ouriques Martins, Mohamad Abdalkader, Mayank Goyal, Thang Huy Nguyen, Thang Huy Nguyen, Mai Duy Ton, Yuyou Zhu, Zhongming Qiu, Zhongming Qiu, Zhongrong Miao, Jildaz Caroff, Michele Romoli, Francesco Diana, Götz Thomalla, Simon Nagel, Else Charlotte Sandset, Bruce Campbell, Tudor G. Jovin, Raul G. Nogueira, Jean Raymond, Thanh N. Nguyen, Thanh N. Nguyen · 发表于：Stroke Vascular and Interventional Neurology · 年份：2022 · DOI：10.1161/svin.122.000538 · 被引用次数：27 · 研究领域：Acute Ischemic Stroke Management、Cerebrovascular and Carotid Artery Diseases、Peripheral Artery Disease Management

Background: The best management of basilar artery occlusion (BAO) remains uncertain. The BASICS (Basilar Artery International Cooperation Study) and the BEST (Basilar Artery Occlusion Endovascular Intervention Versus Standard Medical Treatment) trials reported neutral results. We sought to understand physicians' approaches to BAOs and whether further BAO randomized controlled trials were warranted. Methods: We conducted an online international survey from January to March 2022 to stroke neurologists and neurointerventionalists. Survey questions were designed to examine clinical and imaging parameters under which clinicians would offer (or rescind) a patient with BAO to endovascular therapy (EVT) or best medical management versus enrollment into a randomized clinical trial. Results: Of >3002 invited participants, 1245 responded (41.4% response rate) from 73 countries, including 54.7% stroke neurologists and 43.6% neurointerventionalists. More than 95% of respondents would offer EVT to patients with BAO, albeit in various clinical circumstances. There were 70.0% of respondents who indicated that the BASICS and BEST trials did not change their practice. Only 22.1% of respondents would perform EVT according to anterior circulation occlusion criteria. The selection of patients for BAO EVT by clinical severity, timing, and imaging modality differed according to geography, specialty, and country income level. Over 80% of respondents agreed that further randomized clinical trials for...