MULTIMODAL REPERFUSION THERAPY IN PATIENTS WITH ACUTE BASILAR ARTERY OCCLUSION
- 1 September 2009
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurosurgery
- Vol. 65 (3), 548-553
- https://doi.org/10.1227/01.neu.0000350862.35963.49
Abstract
Multimodal reperfusion therapy (MMRT) has been advocated for the treatment of acute basilar artery occlusion (ABAO). We aimed to identify prognostic factors in patients with ABAO who underwent MMRT.Clinical and radiological data from consecutive ABAO patients were analyzed. All patients underwent MMRT on an emergency basis. Stroke subtypes were categorized according to TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria. Good outcome was defined as a modified Rankin Scale score of 3 or less and poor outcome as a score of 4 or more at 30 days poststroke.Twenty-four patients were included (18 men, 6 women) with a mean age of 54.7 years (age range, 26-70 years). Six patients died (25%), and 8 of the surviving 18 patients (44%) achieved a modified Rankin Scale score of 3 or less at 30 days. We could not identify any clinical or radiological variables that were associated with a greater likelihood of good or poor outcome at 30 days other than the presence of good collateral circulation, which was associated with better outcome on univariate analysis.MMRT resulted in high survival and good outcome rates. We could not identify prognostic factors in patients with ABAO treated with MMRT other than the presence of collateral flow. Our results imply that patients should not be excluded from treatment based on clinical or radiological parameters, and that all patients with ABAO should be given the chance to benefit from therapy.Keywords
This publication has 20 references indexed in Scilit:
- Mechanical thrombectomy with snare in patients with acute ischemic strokeNeuroradiology, 2007
- Multimodal Reperfusion Therapy for Acute Ischemic StrokeStroke, 2006
- Mechanical Thrombolysis in Ischemic Stroke Attributable to Basilar Artery Occlusion as First-Line TreatmentStroke, 2006
- Multimodal Therapy for the Treatment of Severe Ischemic Stroke Combining GPIIb/IIIa Antagonists and Angioplasty After Failure of ThrombolysisStroke, 2005
- Aggressive Therapy With Intravenous Abciximab and Intra-Arterial rtPA and Additional PTA/Stenting Improves Clinical Outcome in Acute Vertebrobasilar OcclusionStroke, 2005
- Clinical and radiological predictors of recanalisation and outcome of 40 patients with acute basilar artery occlusion treated with intra-arterial thrombolysisJournal of Neurology, Neurosurgery & Psychiatry, 2004
- Urgent endovascular revascularization for symptomatic intracranial atherosclerotic stenosisNeurology, 2003
- Intra-arterial thrombolysis in 24 consecutive patients with internal carotid artery T occlusionsJournal of Neurology, Neurosurgery & Psychiatry, 2003
- Intra-arterial Prourokinase for Acute Ischemic StrokeJAMA, 1999
- Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease.Stroke, 1988