Title: Thrombectomy for Basilar Artery Occlusion? <br/>Author: WanTsu Wendy Chang<br/><a href='http://umem.org/profiles/faculty/1322/'>[Click to email author]</a><hr/><ul>
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                <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">The landscape of acute ischemic stroke treatment changed dramatically with endovascular thrombectomy (EVT).</span></span></span></span></li>
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                <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">However, few patients with basilar artery occlusions were included in major EVT trials.</span></span></span></span></li>
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                <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Basilar artery occlusion accounts for 10% of large vessel occlusions and can result in devastating neurological deficits.</span></span></span></span></li>
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                <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">The recently published BASICS trial evaluated the efficacy of EVT within 6 hours of symptom onset in 300 patients with basilar artery occlusion strokes.</span></span></span></span></li>
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                <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">44.2% of the EVT group had a good outcome compared to 37.7% of the medical treatment group (p=0.19).</span></span></span></span>
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                                <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Good outcome was defined as modified Rankin scale of 0 (no symptoms) to 3 (moderate disability but able to walk without assistance) at 90 days.</span></span></span></span></li>
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                                <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Symptomatic intracranial hemorrhage was higher in the EVT group (4.5% vs. 0.7%, p=0.06).</span></span></span></span></span></span></span></span></li>
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                                <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">History of AFib was more common in the EVT group (28.6% vs. 15.1%).</span></span></span></span></span></span></span></span></span></span></span></span></li>
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                <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">It is important to note that this study did not use advanced neuroimaging for patient selection unlike in landmark EVT trials of anterior circulation large vessel occlusion strokes.</span></span></span></span></li>
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        <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><strong><u>Bottom Line</u>:</strong> There is no significant difference between endovascular thrombectomy and medical management for basilar artery occlusion strokes within 6 hours of symptom onset. </span></span></span></span></p>
<fieldset><legend>References</legend>

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        Langezaal LCM, van der Hoeven EJRJ, Mont’Alverne FJA, <em>et al</em>. Endovascular therapy for stroke due to basilar-artery occlusion. <em>N Engl J Med</em>. 2021;384(20):1910-20. </div>
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