Endovascular Treatment for Acute Basilar Artery Occlusion: A Comparison of Arteriosclerotic, Embolic and Tandem Lesions

Purpose To evaluate the safety and efficacy of endovascular treatment (EVT) for patients with acute ischemic stroke (AIS) due to intracranial atherosclerosis-related basilar artery occlusion (ICAS-related BAO) by comparison with embolic and tandem occlusion. Methods We retrospectively reviewed conse...

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Bibliographic Details
Published in:Cardiovascular and interventional radiology 2021-12, Vol.44 (12), p.1954-1963
Main Authors: Yang, Wenjin, Zhang, Lei, Li, Zifu, Zhang, Yongxin, Li, He, Hua, Weilong, Li, Jianan, Zhang, Hongjian, Shen, Hongjian, Xing, Pengfei, Zhang, Yongwei, Hong, Bo, Liu, Jianmin, Yang, Pengfei
Format: Article
Language:English
Subjects:
Angioplasty
Arteriosclerosis
Atherosclerosis
Blood clots
Cardiology
Cardiovascular disease
Cardiovascular system
Catheters
Clinical Investigation
Clinical outcomes
Dissection
Embolisms
Etiology
Hemorrhage
Imaging
Ischemia
Medical imaging
Medicine
Medicine & Public Health
Nuclear Medicine
Occlusion
Patients
Radiology
Reperfusion
Stents
Stroke
Stroke/Neurointerventions
Ultrasound
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Summary:Purpose To evaluate the safety and efficacy of endovascular treatment (EVT) for patients with acute ischemic stroke (AIS) due to intracranial atherosclerosis-related basilar artery occlusion (ICAS-related BAO) by comparison with embolic and tandem occlusion. Methods We retrospectively reviewed consecutive patients with AIS due to BAO who underwent EVT. Patients were assigned to the ICAS-related group and embolic group, and tandem group based on the etiology. Baseline data, procedural details, and clinical outcomes were compared between the three groups. Results A total of 100 patients (ICAS-related group: 31; embolic group: 41; tandem group: 28) were included. No significant difference was observed in the successful reperfusion (mTICI 2b or 3), but the procedural time differed significantly (60 min vs. 43 min vs. 60 min, P  = 0.010). There were no differences in the different intracranial hemorrhage grades among the three groups ( P  = 0.134). After adjusting for baseline differences, there was no significant difference in pairwise comparisons regarding favorable outcome (mRS 0–2), moderate outcome (mRS 0–3), and mortality. Conclusions Endovascular treatment for patients with acute ICAS-related BAO had equal efficacy and safety compared with embolic BAO and tandem BAO. Primary endovascular treatment and rescue modalities were effective treatments for acute ICAS-related BAO.
ISSN:0174-1551
1432-086X
DOI:10.1007/s00270-021-02994-z