Multimodal reperfusion therapy in patients with acute basilar artery occlusion.

Abstract:

OBJECTIVE: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. METHODS: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. RESULTS: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. CONCLUSION: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.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Raphaeli G,Eichel R,Ben-Hur T,Leker RR,Cohen JE

doi

10.1227/01.NEU.0000350862.35963.49

subject

Has Abstract

pub_date

2009-09-01 00:00:00

pages

548-52; discussion 552-3

issue

3

eissn

0148-396X

issn

1524-4040

pii

00006123-200909000-00023

journal_volume

65

pub_type

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