Endovascular thrombectomy versus medical management for basilar artery occlusion stroke with mild neurological deficit – results from the BASILAR registry

作者：Zhenyu Kong, Ye Liang, Hong Wang, Bo Yang, Jianhui Xu, Keping Qiao, Tengfei Fan, Guanxiao Ding, Zihan Qiu, Zeng Zhao, Xiangdong Xie, Shunfu Jiang, Hongmei Xu, Jeffrey L. Saver, Götz Thomalla, Qingwu Yang, Hongfei Sang, Thanh N. Nguyen, Zhongming Qiu, Jun Luo, Mingchao Li, Yong Liang · 发表于：Neurological Research · 年份：2025 · DOI：10.1080/01616412.2025.2559304 · 被引用次数：1 · 研究领域：Acute Ischemic Stroke Management、Spatial Neglect and Hemispheric Dysfunction、Cerebrovascular and Carotid Artery Diseases

Background Endovascular thrombectomy (EVT) benefits basilar artery occlusion (BAO) patients with moderate-to-severe deficits, but its role in patients with mild neurological deficits (NIHSS ≤10) remains controversial. This study aimed to compare clinical and safety outcomes of EVT plus medical management (MM) versus MM alone in acute BAO patients with mild deficits.Methods Ninety-eight patients from the BASILAR registry met the criteria and were included in this analysis (EVT: n = 70; MM: n = 28). Inverse probability weighting (IPW) adjusted for baseline imbalances. A systematic review and meta-analysis of seven studies was conducted to synthesize existing evidence. Interventions included EVT plus MM versus MM alone. The primary outcome was 90-day functional independence (modified Rankin Scale [mRS] 0–2); secondary outcomes included excellent (mRS 0–1) and favorable (mRS 0–3) outcomes, mortality, and symptomatic intracranial hemorrhage (sICH).Results In the BASILAR cohort, EVT was associated with higher likelihood of functional independence (IPW-adjusted odds ratio [aOR] 8.46, 95% CI 2.29–31.17; p < 0.001) versus MM, with no increased risk of sICH (1.3% vs. 0%) and death (aOR 0.35, 95% CI 0.07–1.63, p = 0.18). Meta-analysis confirmed higher association of EVT with higher odds of functional independence (pooled aOR 1.78, 95% CI 1.00–3.18; p = 0.05) and excellent outcomes (aOR 3.98, 95% CI 1.32–11.95; p = 0.01), without elevated risk of sICH and death.Conclusion In acute BAO pa...