Acute Basilar Artery Occlusion: Differences in Characteristics and Outcomes after Endovascular Therapy between Patients with and without Underlying Severe Atherosclerotic Stenosis

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Fig 1.
A 74-year-old male patient with acute stroke due to acute basilar artery occlusion. A, Left vertebral artery angiogram shows an occlusion (arrow) at the proximal segment of the basilar artery. B, Angiogrm obtained after 1 passage of the stent retriever reveals a severe underlying atherosclerotic stenosis (arrow) at the proximal segment of the basilar artery. C, Left vertebral angiogram obtained after intracranial angioplasty and stent placement shows complete recanalization of the basilar artery with good distal perfusion. Arrows indicate the proximal and distal ends of the Wingspan stent. D, Photograph shows small fragmented thrombi retrieved with a Solitaire stent.

Table 1:

Baseline characteristics of the study population

	All Patients (n = 62)	Patients with ICAS (n = 15)	Patients without ICAS (n = 47)	P Value
Age (mean) (yr)	69.6 ± 11.95	67.1 ± 10.03	70.3 ± 12.50	.205
Male sex (No.) (%)	36 (58.1)	12 (80.0)	24 (51.1)	.048
Risk factor (No.) (%)
Hypertension	37 (59.7)	11 (73.3)	26 (55.3)	.216
Diabetes mellitus	14 (22.6)	4 (26.7)	10 (21.3)	.727
Dyslipidemia	16 (25.8)	6 (40.0)	10 (21.3)	.182
Smoking	15 (24.2)	5 (33.3)	10 (21.3)	.489
Coronary artery disease	5 (8.1)	0 (0.0)	5 (10.6)	.323
IV thrombolysis (No.) (%)	17 (27.4)	7 (46.7)	10 (21.3)	.094
Occlusion sites (No.) (%)
Proximal	12 (19.4)	9 (60.0)	3 (6.4)	<.001
Middle	3 (4.8)	2 (13.3)	1 (2.1)	.143
Distal	47 (75.8)	4 (26.7)	43 (91.5)	<.001
Bilateral thalamic infarction (No.) (%)	13 (21.0)	0 (0.0)	13 (27.7)	.027
Baseline NIHSS score (mean)	12.4 ± 6.23	12.7 ± 5.95	12.3 ± 6.37	.773
pc-ASPECTS (median) (IQR)	7 (6–8)	7 (6–8)	7 (6–8)	.794
Time to procedure (mean) (min)	289.6 ± 129.68	309.3 ± 139.65	283.3 ± 127.60	.532
Procedure time (mean) (min)	30.9 ± 17.76	39.0 ± 19.47	28.3 ± 16.56	.006
Time to revascularization (mean) (min)	321.0 ± 136.22	348.3 ± 143.84	312.2 ± 134.12	.459

Note:—IQR indicates interquartile range; pc-ASPECTS, posterior circulation ASPECTS.

Table 2:

Outcomes after endovascular therapy in 62 patients with acute stroke due to BAO

	All Patients (n = 62)	Patients with ICAS (n = 15)	Patients without ICAS (n = 47)	P Value
mTICI 2b or 3 (No.) (%)	60 (96.8)	15 (100.0)	45 (95.7)	NS
mRS 0–2 (No.) (%)	33 (53.2)	9 (60.0)	24 (51.1)	NS
Symptomatic hemorrhage (No.) (%)	1 (1.6)	0 (0.0)	1 (2.1)	NS
Mortality (No.) (%)	10 (16.1)	2 (13.3)	8 (17.0)	NS