Journal ArticleDOI
Basilar artery occlusion
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TLDR
If BAO is recognised early and confirmed with multimodal CT or MRI, intravenous thrombolysis or endovascular treatment can be undertaken, however, the best treatment approach to improve clinical outcome still needs to be ascertained.Abstract:
The clinical presentation of basilar artery occlusion (BAO) ranges from mild transient symptoms to devastating strokes with high fatality and morbidity. Often, non-specific prodromal symptoms such as vertigo or headaches are indicative of BAO, and are followed by the hallmarks of BAO, including decreased consciousness, quadriparesis, pupillary and oculomotor abnormalities, dysarthria, and dysphagia. When clinical findings suggest an acute brainstem disorder, BAO has to be confirmed or ruled out as a matter of urgency. If BAO is recognised early and confirmed with multimodal CT or MRI, intravenous thrombolysis or endovascular treatment can be undertaken. The goal of thrombolysis is to restore blood flow in the occluded artery and salvage brain tissue; however, the best treatment approach to improve clinical outcome still needs to be ascertained.read more
Citations
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Journal ArticleDOI
Time is Brain(stem) in Basilar Artery Occlusion
Mervyn D.I. Vergouwen,Ale Algra,Thomas Pfefferkorn,Christian Weimar,Christina Rueckert,Vincent Thijs,L. Jaap Kappelle,Wouter J. Schonewille +7 more
TL;DR: Early recanalization therapy in patients with BAO is associated with a more favorable outcome with a significant increased chance of a poor outcome when recanAlization therapy is started >6 hours after estimated time of BAO.
Journal ArticleDOI
Three-month and long-term outcomes and their predictors in acute basilar artery occlusion treated with intra-arterial thrombolysis.
Simon Jung,Marie-Luise Mono,Urs Fischer,Aekaterini Galimanis,Oliver Findling,Gian Marco De Marchis,Anja Weck,Krassen Nedeltchev,Giuseppe Colucci,Pasquale Mordasini,Caspar Brekenfeld,Marwan El-Koussy,Jan Gralla,Gerhard Schroth,Heinrich Mattle,Marcel Arnold +15 more
TL;DR: National Institutes of Health Stroke Scale score at admission and age were identified as predictors of outcome, and these predictors should be considered for treatment allocation in future randomized trials.
Journal ArticleDOI
Technical feasibility and application of mechanical thrombectomy with the Solitaire FR Revascularization Device in acute basilar artery occlusion.
Pasquale Mordasini,Caspar Brekenfeld,James V. Byrne,Urs Fischer,Marcel Arnold,Mirjam Rachel Heldner,Rudolf Lüdi,Heinrich Mattle,G Schroth,Jan Gralla +9 more
TL;DR: A multimodal endovascular approach using retrievable stents in BAO has high recanalization rates, with very low complication rates.
Journal ArticleDOI
Trial of Thrombectomy 6 to 24 Hours after Stroke Due to Basilar-Artery Occlusion.
Tudor G Jovin,Chuanhui Li,Longfei Wu,Chuanjie Wu,Jiyan Chen,Changchun Jiang,Zhonghua Shi,Zongen Gao,Cunfeng Song,Wenhuo Chen,Yan-Chao Peng,Chen Yao,Mingyue Wei,Tong Li,Liping Wei,Guodong Xiao,Huanming Yang,Ming Ren,Jiangang Duan,Xinfeng Liu,Qingwu Yang,Yuxiu Liu,Qi-yi Zhu,Wan-chao Shi,Qiyi Zhu,Xiaobo Li,Zaiyu Guo,Qi Yang,Chengbei Hou,Wenbo Zhao,Qingfeng Ma,Yunzhou Zhang,Li-Xin Jiao,Hongqin Zhang,David S Liebeskind,Hui Liang,Ashutosh P Jadhav,Changming Wen,Scott Brown,Liangfu Zhu,Hua-wei Ye,Marc Ribó,Ming-Chao Chang,Haiqing Song,Jun Chen,Xunming Ji +45 more
TL;DR: Among patients with stroke due to basilar-artery occlusion who presented between 6 to 24 hours after symptom onset, thrombectomy led to a higher percentage with good functional status at 90 days than medical therapy but was associated with procedural complications and more cerebral hemorrhages.
Journal ArticleDOI
Mechanical thrombectomy for basilar artery occlusion: efficacy, outcomes, and futile recanalization in comparison with the anterior circulation.
Thomas Raphael Meinel,Johannes Kaesmacher,Panagiotis Chaloulos-Iakovidis,Leonidas Panos,Pasquale Mordasini,Pascal J. Mosimann,Patrik Michel,Steven D. Hajdu,Marc Ribo,Manuel Requena,Christian Maegerlein,Benjamin Friedrich,Vincent Costalat,Amel Benali,Laurent Pierot,Matthias Gawlitza,Joanna D. Schaafsma,Vitor Mendes Pereira,Jan Gralla,Urs Fischer +19 more
TL;DR: In selected patients, similar outcomes can be achieved in BAO and ACLVO patients treated with MT, and Randomized controlled trials comparing patient selection and interventional strategies seem warranted to avoid FR.
References
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Journal ArticleDOI
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TL;DR: Higher rates of recanalization were associated with a newer generation thrombectomy device compared with first-generation devices, but these differences did not achieve statistical significance.
Journal ArticleDOI
The penumbra pivotal stroke trial: safety and effectiveness of a new generation of mechanical devices for clot removal in intracranial large vessel occlusive disease.
TL;DR: The results suggest the Penumbra System allows safe and effective revascularization in patients experiencing ischemic stroke secondary to large vessel occlusive disease who present within 8 hours from symptom onset.
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