Endovascular vs Medical Treatment of Basilar Artery Occlusion

作者：Wei Hu, Chunrong Tao, Rui Li, ZhongJun Chen, Wenhuo Chen, Tingyu Yi, Hao Wang, Peiyang Zhou, Zhihua Cao, Guoyong Zeng, Tao Cui, Junfeng Su, Li Chen, Guoping Wang, Jun Sun, Yuyou Zhu, Li Wang, Chao Zhang, TianLong Liu, Jianlong Song, Xiaozhong Jing, Anmo Wang, Jinjing Wang, Pengfei Xu, Chao Luo, Adnan I. Qureshi, Mohamad Abdalkader, Thanh N. Nguyen, Jeffrey L. Saver, Raul G. Nogueira, Xinfeng Liu · 发表于：JAMA Neurology · 年份：2025 · DOI：10.1001/jamaneurol.2025.5077 · 被引用次数：4 · 研究领域：Acute Ischemic Stroke Management、Cerebrovascular and Carotid Artery Diseases、Peripheral Artery Disease Management

Importance: Endovascular thrombectomy (EVT) has been established as an effective treatment for acute basilar artery occlusion (BAO) in the short term. However, the durability of these benefits over the long term has not been well characterized. Objective: To determine whether the clinical benefits of EVT for acute BAO are sustained at 3 years, with a primary focus on functional outcomes and mortality compared with best medical management alone. Design, Setting, and Participants: This study is a 3-year follow-up extension of a multicenter randomized clinical trial conducted between February 2021 and January 2022, with follow-up data collected through January 2025. The study was designed as an open-label, assessor-blinded trial to evaluate the long-term efficacy of EVT. The trial was conducted at 36 comprehensive stroke centers across China, representing a diverse, population-based setting that enhances the generalizability of the results. A total of 340 patients with acute BAO within 12 hours of estimated symptom onset were randomly assigned to the thrombectomy or control group. Eligible participants were adults with imaging-confirmed BAO and without contraindications to endovascular therapy. Of the randomized patients, 307 (90.3%) completed 3-year follow-up-203 in the thrombectomy group and 104 in the control group. Interventions: Participants in the thrombectomy group received EVT in combination with best medical management, while the control group received best medical mana...