Abstract
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.
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Abbreviations
- EVT:
-
Endovascular treatment
- ICAS:
-
Intracranial atherosclerosis
- BAO:
-
Basilar artery occlusion
- BATMAN:
-
The Basilar Artery on Computed Tomography Angiography
- mTICI:
-
Modified Thrombolysis in Cerebral Infarction
- mRS:
-
Modified Rankin Scale
- ICH:
-
Intracranial hemorrhage
- NIHSS:
-
National Institute of Health Stroke Scale
- LVO:
-
Large vessel occlusion
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Acknowledgements
The authors state that this work has received funding from Intelligent Medical Special Research Project (No. 2018ZHYL0218); Specialty Feature Construction Project of Pudong Health and Family Planning Commission of Shanghai (No. PWZzb2017-09); Scientific research program of Shanghai Science and Technology Commission (No.18ZR1438500)
Funding
This study was funded by Intelligent Medical Special Research Project (No. 2018ZHYL0218); Specialty Feature Construction Project of Pudong Health and Family Planning Commission of Shanghai (No. PWZzb2017-09); Scientific research program of Shanghai Science and Technology Commission (No.18ZR1438500).
This study sponsors were not involved in the study design, study conduct, article preparation or review.
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Authors and Affiliations
Contributions
Wenjin Yang: Data collection, paper drafting, and data statistics. Lei Zhang: Data collection, paper modify, and data statistics. Zifu Li: The surgical treatment. Yongxin Zhang: The surgical treatment. He Li: The postoperative management. Weilong Hua: The postoperative management. Jianan Li: Data record. Hongjian Zhang: Follow-up management. Hongjian Shen: Follow-up management. Pengfei Xing: Data record. Yongwei Zhang: The assessment of vessel occlusion. Bo Hong: The assessment of vessel occlusion. Jianmin Liu: Supervision, the consensus for etiology of vessel occlusion. Pengfei Yang: Study design, project administration, and funding acquisition.
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Yang, W., Zhang, L., Li, Z. et al. Endovascular Treatment for Acute Basilar Artery Occlusion: A Comparison of Arteriosclerotic, Embolic and Tandem Lesions. Cardiovasc Intervent Radiol 44, 1954–1963 (2021). https://doi.org/10.1007/s00270-021-02994-z
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DOI: https://doi.org/10.1007/s00270-021-02994-z