Early and late basilar artery thrombectomy time window outcomes

被引:3
作者
Mierzwa, Adam T. [1 ,2 ]
Rao, Rahul [1 ,2 ]
Al Kasab, Sami [3 ]
Nelson, Ashley [3 ]
Ortega-Gutierrez, Santiago [4 ]
Vivanco-Suarez, Juan [4 ]
Farooqui, Mudassir [4 ]
Jadhav, Ashutosh P. [5 ]
Desai, Shashvat [5 ]
Toth, Gabor [6 ]
Alrohimi, Anas [6 ]
Nguyen, Thanh N. [7 ]
Klein, Piers [7 ]
Abdalkader, Mohamad [7 ]
Salahuddin, Hisham [8 ]
Pandey, Aditya [9 ]
Wilseck, Zachary [9 ]
Koduri, Sravanthi [9 ]
Vora, Nirav [10 ]
Aladamat, Nameer [1 ]
Gharaibeh, Khaled [1 ]
Afreen, Ehad [1 ,2 ]
Zaidi, Syed [1 ,2 ]
Jumaa, Mouhammad [1 ,2 ]
机构
[1] Univ Toledo, Dept Neurol, Coll Med & Life Sci, Toledo, OH 43614 USA
[2] Promed Stroke Network, Toledo, OH 43606 USA
[3] Med Univ South Carolina, Dept Neurol & Neurosurg, Charleston, SC USA
[4] Univ Iowa, Iowa City, IA USA
[5] Barrow Neurol Inst, Phoenix, AZ USA
[6] Cleveland Clin Fdn, Cleveland, OH USA
[7] Boston Univ, Dept Neurol Radiol, Chobanian & Avedisian Sch Med, Boston, MA USA
[8] Antelope Valley Hosp, Dept Neurol, Los Angeles, CA USA
[9] Univ Michigan, Dept Neurosurg, Ann Arbor, MI USA
[10] OhioHlth Riverside Methodist Hosp, Columbus, OH USA
来源
FRONTIERS IN NEUROLOGY | 2024年 / 15卷
关键词
stroke; basilar artery; thrombectomy; large-vessel occlusion; time window; ENDOVASCULAR TREATMENT; ISCHEMIC-STROKE; OCCLUSION; THERAPY; TRIAL; BRAIN;
D O I
10.3389/fneur.2024.1352310
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Importance: Stroke-to-recanalization time is a strong predictor of outcomes in anterior circulation large-vessel occlusion (LVO). The authors aimed to evaluate functional outcomes in early (<6 h) vs. late (6-24 h) time windows for thrombectomy-treated basilar artery occlusions. Methods: Patients were derived from the Posterior Circulation Ischemic Stroke Evaluation: Analyzing Radiographic and Intra-procedural Predictors of Mechanical Thrombectomy (PC-SEARCH) Registry and retrospectively analyzed early and late basilar artery thrombectomy time windows cohorts. Patients were dichotomized based on the last known well and correlated to 90-day functional outcomes (mRS 0-3). A multiple logistic regression analysis was performed. Results: A total of 405 patients were included in this study: 216 and 189 patients in the early and late time windows, respectively. Baseline demographic, stroke, radiographic, and intraprocedural characteristics were similar between the groups. A total of 99 (46%) and 79 (42%) patients in the early and late time windows, respectively, achieved favorable functional outcomes at 90 days (p = 0.41), and multiple logistic regression analysis did not reveal differences between cohorts (OR: 0.74; 95% CI: 0.46-1.19; p = 0.22). Symptomatic hemorrhage (7% vs. 5%; p = 0.69) and neurological complications (8% vs. 9%; p = 0.83) were similar between the groups; however, hospital complications were more common in the early time window cohort (22% vs. 13%; p = 0.01). Conclusion: The early and late thrombectomy time windows can achieve similar rates of 90-day favorable functional outcomes. However, timely thrombectomy influences the likelihood of achieving excellent functional outcomes (mRS <= 2) within the early time window.
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页数:8
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