Effect of stroke etiology on endovascular treatment in patients with acute basilar artery occlusion

Author(s):  
Tian TIAN ◽  
Zhongzhen LI ◽  
Miao YU ◽  
Yunpeng XIE ◽  
Wenhao SUN ◽  
...  
2019 ◽  
Author(s):  
Wenjie Zi ◽  
Zhongming Qiu ◽  
Deping Wu ◽  
Fengli Li ◽  
Hansheng Liu ◽  
...  

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Fengli Li ◽  
Hongfei Sang ◽  
Jiaxing Song ◽  
Zhangbao Guo ◽  
Shuai Liu ◽  
...  

Background and Objective: To report the results of clinical follow-up at 1 year among patients in the BASILAR registry. Design, Setting, and Participants: The BASILAR study was an investigator-initiated prospective registry, which consecutively enrolled stroke patients with acute basilar artery occlusion from 47 comprehensive stroke centers in China between January, 2014, and May, 2019. Patients were divided into conventional treatment or endovascular treatment groups according to the treatment their received. We assessed clinical outcomes 1 year after patients were enrolled in the BASILAR registry. Main Outcomes and Measures: The primary outcome was the score on the modified Rankin scale (range, 0 to 6 points, with higher scores indicating more severe disability) at 1 year assessed as a common odds ratio using ordinal logistic regression shift analysis, adjusted for prespecified prognostic factors. Secondary outcomes included categories scores of the modified Rankin scale at 1 year (0 to 1 [excellent outcome], 0 to 2 [good outcome], and 0 to 3 [favorable outcome]), and death from any cause during the 1-year period after enrollment. Results: Of the 829 patients who were enrolled in the original study, 1-year data for this extended follow-up study were available for 785 patients (94.7%). The distribution of outcomes on the modified Rankin scale favored endovascular treatment over conventional treatment (adjusted common odds ratio, 4.50; 95% confidence interval [CI], 2.81 to 7.29; P < 0.001). There were significant differences between the treatment groups in the percentage of patients who had excellent outcome, good outcome and favorable outcome. The cumulative 1-year mortality rate was 54.6% in the endovascular treatment group and 83.5% in the conventional treatment group (adjusted hazard ratio, 4.36; 95% CI, 2.69 to 7.29; P < 0.001). Conclusions and Relevance: In this extended follow-up study, the beneficial effect of endovascular treatment on functional outcome at 1 year in patients with acute basilar artery occlusion was similar to that reported at 90 days in the original study.


Stroke ◽  
2021 ◽  
Author(s):  
Fengli Li ◽  
Hongfei Sang ◽  
Jiaxing Song ◽  
Zhangbao Guo ◽  
Shuai Liu ◽  
...  

Background and Purpose: The BASILAR registry, a nationwide prospective nonrandomized study conducted in China, enrolled consecutive patients with acute basilar artery occlusion receiving endovascular treatment or conventional-treatment from January 2014 to May 2019. This article aimed to report the results of clinical follow-up at one year among these patients. Methods: The primary outcome was the modified Rankin Scale at one year, assessed as a common odds ratio using ordinal logistic regression analysis adjusted for prespecified prognostic factors. Secondary outcomes included the modified Rankin Scale-based outcome group at one year (0–1, 0–2, or 0–3) and all-cause death. Results: Of the 829 patients enrolled in the original BASILAR registry, one-year data were available for 785 patients (94.7%). The distribution of outcomes on the modified Rankin Scale favored endovascular treatment over conventional-treatment (adjusted common odds ratio, 4.50 [95% CI, 2.81–7.29]; P <0.001). The cumulative one-year mortality rate was 54.6% in the endovascular treatment group versus 83.5% in the conventional-treatment group (adjusted odds ratio, 4.36 [95% CI, 2.69–7.29]; P <0.001). Conclusions: The beneficial effect of endovascular treatment on functional outcome at one year in patients with acute basilar artery occlusion is similar to that reported at 90 days in the original study. REGISTRATION: URL: http://www.chictr.org.cn ; Unique identifier: ChiCTR1800014759.


2015 ◽  
Vol 70 (5) ◽  
pp. e20-e27 ◽  
Author(s):  
T. Dorňák ◽  
R. Herzig ◽  
M. Kuliha ◽  
R. Havlíček ◽  
D. Školoudík ◽  
...  

2019 ◽  
Vol 401 ◽  
pp. 29-33 ◽  
Author(s):  
Junya Kaneko ◽  
Takahiro Ota ◽  
Takashi Tagami ◽  
Kyoko Unemoto ◽  
Keigo Shigeta ◽  
...  

2018 ◽  
Vol 60 (6) ◽  
pp. 651-659 ◽  
Author(s):  
Chuanhui Li ◽  
Wenbo Zhao ◽  
Chuanjie Wu ◽  
Shuyi Shang ◽  
Jian Chen ◽  
...  

2013 ◽  
Vol 333 ◽  
pp. e234
Author(s):  
T. Dorňák ◽  
R. Herzig ◽  
D. Školoudík ◽  
D. Šaňák ◽  
M. Kuliha ◽  
...  

2021 ◽  
Vol 12 ◽  
Author(s):  
Anna Kufner ◽  
Matthias Endres ◽  
Michael Scheel ◽  
Christoph Leithner ◽  
Christian H. Nolte ◽  
...  

Background: Thrombus perviousness (TP) quantified by thrombus attenuation increase (TAI) assessed on acute non-contrast computed tomography (NCCT) and CT angiography (CTA) may be associated with stroke etiology in anterior circulation ischemic stroke. We investigated whether TP is associated with stroke etiology and recanalization after mechanical thrombectomy in patients with acute basilar artery occlusion (BAO).Methods: Eighty patients with complete BAO and in-house acute imaging from a prospectively maintained database were included. Two raters independently segmented the complete thrombus on co-registered NCCT and CTA to determine TAI in Hounsfield units (HUCTA–HUNCCT); averaged values of the raters were used for analysis. Recanalization to modified treatment in cerebral ischemia (mTICI) score 2b/3 was considered successful, and 90-day modified Rankin Scale score 0–2 was considered favorable.Results: TAI did not differ between patients with different stroke etiologies; median TAI in patients with cardioembolic stroke (n = 36) was −0.47 (interquartile range −4.08 to 7.72), 1.94 (−8.14 to 10.75) in patients with large artery atherosclerosis (LAA; n = 25), and −0.99 (−6.49 to 5.40) in patients with stroke of undetermined origin (n = 17; p = 0.955). Binary logistic regression analyses did not identify TAI as an independent indicator of cardioembolic stroke (adjusted odds ratio [OR] vs. LAA stroke: 1.0 [95% CI: 0.95–1.0], p = 0.751). There was no association with successful recanalization (adjusted OR 1.4 [0.70–2.7], p = 0.345) or favorable outcome (adjusted OR 1.1 [95% CI: 0.94–1.2], p = 0.304).Conclusion: In contrast to proximal middle cerebral artery occlusions, TP in BAO patients is not associated with cardioembolic stroke etiology. Larger confirmatory studies to establish the potential role of TP for clinical applications should focus on patients with anterior circulation stroke.


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