PDF icon Download PDF
J Neurol Surg B Skull Base 2024; 85(03): 234-240
DOI: 10.1055/a-2065-9562
Original Article

A Study on the Efficacy of Thrombectomy in Patients with Atherosclerotic and Cardioembolic Basilar Artery Occlusion

Fulei Chen   *
1   Department of Neurosurgery, First Affiliated Hospital of Shihezi University School of Medicine, Shihezi, China
,
Linzhi Dai   *
2   Department of Neurosurgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
,
Jiangtao Dong
2   Department of Neurosurgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
,
Licang Zhu
2   Department of Neurosurgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
,
Yang Li
2   Department of Neurosurgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
,
Lei Zhang
2   Department of Neurosurgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
,
Dong Zhao
2   Department of Neurosurgery, The First Affiliated Hospital of Shihezi University, Shihezi, China
› Author Affiliations
Funding This research received funding from National Natural Science Foundation of China, No. 81960222; The Young and Middle-Aged Leading Talents in Scientific and Technological Innovation of XPCC, No. 2020CB011.
› Further Information
Also available atMedOne
   Permissions and Reprints
Preview

Abstract

Background Studies on basilar artery occlusion are relatively few compared with those of anterior circulation stroke. The aim of the present study was to compare the efficacy of endovascular therapy (EVT) in patients with basilar artery occlusion classified as large artery atherosclerosis (LAA) and cardioembolism (CE), and to analyze the independent risk factors affecting the prognosis of EVT.

Methods A total of 123 people were assigned to the LAA and CE groups (97 to the LAA and 26 to the CE). The primary outcome was a modified Rankin Scale (mRS) score of 2 or lower at 90 days. The primary safety outcome was mortality at 90 days. Secondary safety endpoints included the rates of symptomatic intracranial hemorrhage and reinfarction. Multiple logistic regression was used to screen out independent risk factors for EVT prognosis of the LAA and CE groups.

Results In the analysis, the patients with LAA stroke had better collateral circulation (American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology [SIR] score of 2–4; 61.9 vs. 19.2%, p = 0.000), and higher angioplasty rate (32.0 vs. 3.8%, p = 0.002). The proportions of patients with a 90-day mRS score of 0 to 2 and 90-day mortality were not found to be statistically significant between the two groups. Multivariate logistic regression analysis indicated that age, SIR, white blood cell, blood glucose, and modified thrombolysis in cerebral infarction were independent risk factors for the poor prognosis of EVT in the LAA group.

Conclusion Although there were differences in clinical characteristics and imaging features between LAA and CE, there was no evidence of a significant difference in prognosis after EVT. In addition, the National Institutes of Health Stroke Scale score was not among the independent risk factors affecting the prognosis of the LAA group.

Keywords

basilar artery occlusion - intravascular therapy - large artery atherosclerosis - cardioembolism

* Both the authors contributed equally to this article.




Publication History

Received: 01 October 2022

Accepted: 27 March 2023

Accepted Manuscript online:
30 March 2023

Article published online:
01 June 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany