TY - JOUR
TI - Bridging Thrombolysis versus Direct Mechanical Thrombectomy in Stroke Due to Basilar Artery Occlusion.
AU - Siow, Isabel
AU - Tan, Benjamin Y. Q.
AU - Lee, Keng Siang
AU - Ong, Natalie
AU - Toh, Emma
AU - Gopinathan, Anil
AU - Yang, Cunli
AU - Bhogal, Pervinder
AU - Lam, Erika
AU - Spooner, Oliver
AU - Meyer, Lukas
AU - Fiehler, Jens
AU - Papanagiotou, Panagiotis
AU - Kastrup, Andreas
AU - Alexandrou, Maria
AU - Zubel, Seraphine
AU - Wu, Qingyu
AU - Mpotsaris, Anastasios
AU - Maus, Volker
AU - Anderson, Tommy
AU - Gontu, Vamsi
AU - Arnberg, Fabian
AU - Lee, Tsong Hai
AU - Chan, Bernard P. L.
AU - Seet, Raymond C. S.
AU - Teoh, Hock Luen
AU - Sharma, Vijay K.
AU - Yeo, Leonard L. L.
JO - International Journal of Stroke
PY - 2022
VL - 24
TODO - 1
SP - 128--137
PB - 
SN - 1747-4930, 1747-4949
TODO - 10.5853/jos.2021.02082
TODO - Stroke, Thrombectomy, Basilar artery, Thrombolytic therapy, Vertebrobasilar insufficiency
TODO - BACKGROUND AND PURPOSE: Mechanical thrombectomy (MT) is an effective treatment for patients with basilar artery occlusion (BAO) acute ischemic stroke. It remains  unclear whether bridging intravenous thrombolysis (IVT) prior to MT confers any  benefit. This study compared the outcomes of acute BAO patients who were treated  with direct MT versus combined IVT plus MT. METHODS: This multicenter retrospective  cohort study included patients who were treated for acute BAO from eight  comprehensive stroke centers between January 2015 and December 2019. Patients  received direct MT or combined bridging IVT plus MT. Primary outcome was favorable  functional outcome defined as modified Rankin Scale 0-3 measured at 90 days.  Secondary outcome measures included mortality and symptomatic intracranial  hemorrhage (sICH). RESULTS: Among 322 patients, 127 (39.4%) patients underwent  bridging IVT followed by MT and 195 (60.6%) underwent direct MT. The mean±standard  deviation age was 67.5±14.1 years, 64.0% were male and median National Institutes of  Health Stroke Scale was 16 (interquartile range, 8 to 25). At 90-day, the rate of  favorable functional outcome was similar between the bridging IVT and direct MT  groups (39.4% vs. 34.4%, P=0.361). On multivariable analyses, bridging IVT was not  as Comorbidisociated with favorable functional outcome, mortality or sICH. In  subgroup analyses, patients with underlying atherosclerosis treated with bridging  IVT compared to direct MT had a higher rate of favorable functional outcome at 90  days (37.2% vs. 15.5%, P=0.013). CONCLUSIONS: Functional outcomes were similar in  BAO patients treated with bridging IVT versus direct MT. In the subgroup of patients  with underlying large-artery atherosclerosis stroke mechanism, bridging IVT may  potentially confer benefit and this warrants further investigation.
ER -