Endovascular clot retrieval for acute ischaemic stroke due to basilar artery occlusion in childhood

2020 ◽  
Vol 62 (10) ◽  
pp. 1221-1223 ◽  
Author(s):  
Emma Macdonald‐Laurs ◽  
Jason Wenderoth ◽  
Michael Cardamone ◽  
Hugo Sampaio ◽  
P Ian Andrews
Keyword(s):  
Ischaemic Stroke ◽  
Basilar Artery ◽  
Acute Ischaemic Stroke ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion

scholarly journals Endovascular treatment with or without intravenous alteplase for acute ischaemic stroke due to basilar artery occlusion

2021 ◽  
pp. svn-2021-001242
Author(s):  
Ximing Nie ◽  
David Wang ◽  
Yuehua Pu ◽  
Yufei Wei ◽  
Qixuan Lu ◽  
...  
Keyword(s):  
Ischaemic Stroke ◽  
Endovascular Treatment ◽  
Basilar Artery ◽  
Acute Ischaemic Stroke ◽  
Functional Outcomes ◽  
Meta Analysis ◽  
Functional Independence ◽  
Artery Occlusion ◽  
Lower Percentage ◽  
Basilar Artery Occlusion

Background and purposeIt remains controversial if endovascular treatment (EVT) can improve the outcome of patients with acute basilar artery occlusion (BAO). This study aims to compare the functional outcomes between EVT with and without intravenous thrombolysis (IVT) first in patients who had acute ischaemic stroke (AIS) due to BAO.MethodsPatients who had AIS with BAO who underwent EVT within 24 hours of onset were enrolled in this multicentre cohort study, and the efficacy and safety were compared between IVT+EVT and direct EVT. The primary outcome was 90-day functional independence. All outcomes were assessed with adjusted OR (aOR) from the multivariable logistic regression. In addition, a meta-analysis was performed on all recently published pivotal studies on functional independence after EVT in patients with BAO.ResultsOf 310 enrolled patients with BAO, 241 (78%) were treated with direct EVT and 69 (22%) with IVT+EVT. Direct EVT was associated with a worse functional outcome (aOR, 0.46 (95% CI 0.24 to 0.85), p=0.01). IVT+EVT was associated with a lower percentage of patients who needed ≥3 passes of stent retriever (10.14% vs 20.75%). The meta-analysis regression revealed a potential positive correlation between bridging with IVT first and functional independence (r=0.14 (95% CI 0.05 to 0.24), p<0.01).ConclusionsThis study showed that compared with direct EVT, EVT with IVT first was associated with better functional outcomes in patients with BAO treated within 24 hours of onset. The meta-analysis demonstrated similar favourable efficacy of IVT first followed by EVT in patients with BAO.

Bridging versus direct endovascular therapy in basilar artery occlusion

2021 ◽  
pp. jnnp-2020-325328
Author(s):  
Sergio Nappini ◽  
Francesco Arba ◽  
Giovanni Pracucci ◽  
Valentina Saia ◽  
Danilo Caimano ◽  
...  
Keyword(s):  
Ischaemic Stroke ◽  
Functional Outcome ◽  
Basilar Artery ◽  
Endovascular Therapy ◽  
Recombinant Tissue Plasminogen Activator ◽  
Artery Occlusion ◽  
Lower Mortality ◽  
Basilar Artery Occlusion ◽  
Bridging Therapy ◽  
Procedural Complications

BackgroundWe evaluated safety and efficacy of intravenous recombinant tissue Plasminogen Activator plus endovascular (bridging) therapy compared with direct endovascular therapy in patients with ischaemic stroke due to basilar artery occlusion (BAO).MethodsFrom a national prospective registry of endovascular therapy in acute ischaemic stroke, we selected patients with BAO. We compared bridging and direct endovascular therapy evaluating vessel recanalisation, haemorrhagic transformation at 24–36 hours; procedural complications; and functional outcome at 3 months according to the modified Rankin Scale. We ran logistic and ordinal regression models adjusting for age, sex, National Institutes of Health Stroke Scale (NIHSS), onset-to-groin-puncture time.ResultsWe included 464 patients, mean(±SD) age 67.7 (±13.3) years, 279 (63%) males, median (IQR) NIHSS=18 (10–30); 166 (35%) received bridging and 298 (65%) direct endovascular therapy. Recanalisation rates and symptomatic intracerebral haemorrhage were similar in both groups (83% and 3%, respectively), whereas distal embolisation was more frequent in patients treated with direct endovascular therapy (9% vs 3%; p=0.009). In the whole population, there was no difference between bridging and direct endovascular therapy regarding functional outcome at 3 months (OR=0.79; 95% CI=0.55 to 1.13). However, in patients with onset-to-groin-puncture time ≤6 hours, bridging therapy was associated with lower mortality (OR=0.53; 95% CI=0.30 to 0.97) and a shift towards better functional outcome in ordinal analysis (OR=0.65; 95% CI=0.42 to 0.98).ConclusionsIn ischaemic stroke due to BAO, when endovascular therapy is initiated within 6 hours from symptoms onset, bridging therapy resulted in lower mortality and better functional outcome compared with direct endovascular therapy.

scholarly journals Predicting mortality in acute ischaemic stroke treated with mechanical thrombectomy: analysis of a multicentre prospective registry

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e043415
Author(s):  
Hao Li ◽  
Shi-sheng Ye ◽  
Yuan-Ling Wu ◽  
Sheng-Ming Huang ◽  
Yong-Xin Li ◽  
...  
Keyword(s):  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
Mechanical Thrombectomy ◽  
Fasting Blood Glucose ◽  
Area Under The Curve ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion ◽  
Clinical Trial Registry ◽  
Previous Stroke ◽  
Receiver Operator Curve Analysis

ObjectivesWe aimed to determine predictors of mortality within 90 days and develop a simple score for patients with mechanical thrombectomy (MT).DesignAnalysis of a multicentre prospective registry.SettingIn six participating centres, patients who had an acute ischaemic stroke (AIS) treated by MT between March 2017 and May 2018 were documented prospectively.Participants224 patients with AIS were treated by MT.ResultsOf 224 patients, 49 (21.9%) patients died, and 87 (38.8%) were independent. Variables associated with 90-day mortality were age, previous stroke, admission National Institutes of Health Stroke Scale (NIHSS), fasting blood glucose and occlusion site. Logistic regression identified four variables independently associated with 90-day mortality: age ≥80 years (OR 3.26, 95% CI 1.45 to 7.33), previous stroke (OR 2.33, 95% CI 1.04 to 5.21), admission NIHSS ≥18 (OR 2.37, 95% CI 1.13 to 4.99) and internal carotid artery or basilar artery occlusion (OR 2.92, 95% CI 1.34 to 6.40). Using these data, we developed predicting 90-day mortality of AIS with MT (PRACTICE) score ranging from 0 to 6 points. The receiver operator curve analysis found that PRACTICE score (area under the curve (AUC)=0.744, 95% CI 0.669 to 0.820) was numerically better than iScore (AUC=0.661, 95% CI 0.577 to 0.745) and Predicting Early Mortality of Ischemic Stroke score (AUC=0.638, 95% CI 0.551 to 0.725) for predicting 90-day mortality.ConclusionsWe developed a simple score to estimate the 90-day mortality of patients who had an AIS treated with MT. But the score needs to be prospectively validated.Trial registration numberChinese Clinical Trial Registry (ChiCTR-OOC-17013052).

Endovascular Treatment for Acute Basilar Artery Occlusion: A Nationwide Prospective Registry

2019 ◽  
Author(s):  
Wenjie Zi ◽  
Zhongming Qiu ◽  
Deping Wu ◽  
Fengli Li ◽  
Hansheng Liu ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Basilar Artery ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion

Late recanalization of basilar artery occlusion in a previously healthy 17-month-old child

2017 ◽  
pp. bcr-2017-013277
Author(s):  
D Andrew Wilkinson ◽  
Aditya S Pandey ◽  
Hugh J Garton ◽  
Luis Savastano ◽  
Julius Griauzde ◽  
...  
Keyword(s):  
Basilar Artery ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion

Isolated basilar artery occlusion by parietal dissection after severe chest and minor head trauma

1998 ◽  
Vol 16 (6) ◽  
pp. 614-616 ◽  
Author(s):  
Massimo Gallerani ◽  
Vanni Veronesi ◽  
Stefano Ceruti ◽  
Giorgio Mantovani ◽  
Reza Ghadirpour
Keyword(s):  
Head Trauma ◽  
Basilar Artery ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion ◽  
Minor Head Trauma

scholarly journals Predictors of Good Outcome After Stent-Retriever Thrombectomy in Acute Basilar Artery Occlusion

Stroke ◽  
2015 ◽  
Vol 46 (10) ◽  
pp. 2972-2975 ◽  
Author(s):  
Woong Yoon ◽  
Seul Kee Kim ◽  
Tae Wook Heo ◽  
Byung Hyun Baek ◽  
Yun Young Lee ◽  
...  
Keyword(s):  
Basilar Artery ◽  
Artery Occlusion ◽  
Stent Retriever ◽  
Basilar Artery Occlusion ◽  
Good Outcome

scholarly journals Endovascular Treatment in Acute Basilar Artery Occlusion “Experience in Indian Patients”

2019 ◽  
Author(s):  
Pokhraj Prakashchandra Suthar ◽  
Hemen I. Vithlani ◽  
Kamaldeep Chawla
Keyword(s):  
Endovascular Treatment ◽  
Basilar Artery ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion ◽  
Indian Patients
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