Basilar artery occlusion (BAO) is a life-threatening disorder for which there is no definite therapy. While there is a well-established link between quicker endovascular therapy (EVT) treatment times and better anterior circulation results, it was unclear if this link occurs for patients with BAO. For a study, researchers used patient-level data from the Get With The Guidelines-Stroke national US registry, which was gathered prospectively between January 2015 and December 2019. Individuals with BAO who were treated with EVT within 24 hours of symptom onset were identified. In-hospital mortality, discharge home, ambulatory at discharge, independent at discharge (modified Rankin Scale score 0 to 2), considerable reperfusion (modified Thrombolysis in Cerebral Infarction score 2b or 3), and symptomatic intracranial bleeding were the major outcomes investigated. In addition, they looked at the relationship between time from symptom start to EVT therapy and results using logistic regression models.
The median age of 3,015 BAO patients treated with EVT was 65.9 years, 38.8% were female, and the median National Institutes of Health Stroke Scale score at presentation was 17 (interquartile range, 8–26). The average time from commencement to EVT was 406 minutes (interquartile range: 252–688). From 2015 to 2019, the median duration from onset to EVT increased (380–411 minutes; P=0.016), although the proportion of patients treated within 6 hours of symptom onset did not change (48.4% –44.0%; P=0.17). After adjusting for patient and hospital-level factors, the odds of in-hospital mortality (aOR, 0.55 [95% CI, 0.45–0.68]) and symptomatic intracranial hemorrhage (aOR, 0.52 [95% CI, 0.32–0.84]) were significantly lower, while the odds of ambulation at discharge (aOR, 1.72 [95% CI, 1.37–2.16]), discharge home (aOR, 2.19 [95% CI, 1.73–2.77]), and independence at discharge (aOR, 2.21 [95% CI, 1.66–2.95]) when onset to EVT time was ≤6 hours compared with >6 hours. The fastest decay in good outcomes per hour occurred within 6 hours of symptom onset. Faster therapy from the beginning of symptoms was linked to better results in individuals getting EVT for BAO. The findings backed current attempts to treat BAO patients with EVT as quickly as possible.
Reference:www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.056554
