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Endovascular treatment for acute basilar artery occlusion: descriptive analysis of the experience in a comprehensive stroke centre

  • Ignacio Saldaña-Inda1
  • Herbert Tejada-Meza1,2,3
  • Alberto Sainz-Pardo4
  • Cristina Moreno-Loscertales1
  • Javier Marta-Moreno1,3

1Stroke Unit, Department of Neurology. Hospital Universitario Miguel Servet, Zaragoza, Spain

2Interventional Neuroradiology Unit, Department of Radiology. Hospital Universitario Miguel Servet, Zaragoza, Spain

3Instituto de Investigación Sanitaria de Aragón (IISAragón), Zaragoza, Spain

4Department of Anaesthesia, Hospital Universitario Miguel Servet, Zaragoza, Spain

DOI: 10.22514/sv.2021.038 Vol.17,Issue 4,July 2021 pp.125-131

Submitted: 08 January 2021 Accepted: 01 February 2021

Published: 08 July 2021

*Corresponding Author(s): Ignacio Saldaña-Inda E-mail: inakisaldana@gmail.com

Abstract

Objectives: To describe the clinical and epidemiological characteristics of patients with basilar artery occlusion (BAO) treated with mechanical thrombectomy (MT) in Aragón, and to compare its anaesthetic management, technical effectivity, security, and prognosis with those of anterior circulation.

Methods: 322 patients from the prospective registry of mechanical thrombectomies from Aragon were assessed: 29 with BAO and 293 with an anterior circulation large vessel occlusion. Baseline characteristics, procedural, clinical and safety outcomes variables were compared.

Results: Out of 29 patients with BAO that underwent endovascular therapy (62.1% men; average age 69.8 ± 14.05 years) 18 (62.1%) received endovascular therapy (EVT) alone and 11 (37.9%) EVT plus intravenous thrombolysis. Atherothrombotic stroke was the most common etiology (41%). The BAO group had longer Door-to-groin (160 vs 141 min; P = 0.043) and Onset-to-reperfusion times (340 vs 297 min; P = 0.005), and higher use of general anaesthesia (60.7% vs 14.7%; P < 0.01). No statistically significant difference was found for Procedure time (60 vs 50 min; P = 0.231) nor the rate of successful recanalization (72.4% vs 82.7%; P = 0.171). Functional independence at 90 days was significantly worse in the BAO group (17.9% vs 38.2%; P < 0.01).

Conclusions: Patients with basilar artery occlusion had higher morbimortality despite similar angiographic results. Mechanical thrombectomy for BAOs is a safe and effective procedure in selected patients. A consensus about the effect of anaesthesia has yet to be reached, for BAO general anaesthesia remains the most frequently used technique.


Keywords

Mechanical thrombectomy; Acute stroke; Basilar artery occlusion; Aragón; Posterior circulation; General anaesthesia


Cite and Share

Ignacio Saldaña-Inda,Herbert Tejada-Meza,Alberto Sainz-Pardo,Cristina Moreno-Loscertales,Javier Marta-Moreno. Endovascular treatment for acute basilar artery occlusion: descriptive analysis of the experience in a comprehensive stroke centre. Signa Vitae. 2021. 17(4);125-131.

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