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
Endovascular treatment versus standard medical treatment for vertebrobasilar artery occlusion (BEST): an open-label, randomised controlled trial.
Xinfeng Liu,Xinfeng Liu,Qiliang Dai,Ruidong Ye,Wenjie Zi,Wenjie Zi,Yuxiu Liu,Huaiming Wang,Wusheng Zhu,Minmin Ma,Qin Yin,Min Li,Xinying Fan,Wen Sun,Yunfei Han,Qiushi Lv,Rui Liu,Dong Yang,Zhonghua Shi,Dequan Zheng,Xiaorong Deng,Yue Wan,Zhen Wang,Yu Geng,Xingyu Chen,Zhiming Zhou,Geng Liao,Ping Jin,Yumin Liu,Xintong Liu,Meng Zhang,Feng Zhou,Hongchao Shi,Yunfeng Zhang,Fuqiang Guo,Congguo Yin,Guozhong Niu,Mei Zhang,Xueli Cai,Qiyi Zhu,Zhonglun Chen,Yingchun Liang,Bing Li,Min Lin,Wei Wang,Haowen Xu,Xinmin Fu,Wenhua Liu,Xiguang Tian,Zili Gong,Haicun Shi,Chuanming Wang,Penghua Lv,Zhonghai Tao,Liangfu Zhu,Shiquan Yang,Wei Hu,Pingzhou Jiang,David S Liebeskind,Vitor Mendes Pereira,Thomas W. Leung,Bernard Yan,Stephen M. Davis,Gelin Xu,Raul G Nogueira,Yunyun Xiong,Zongjie Shi,Weihong Zheng,Xianjun Huang,Yong Liu,Huagang Li,Kaifu Ke,Shu Yang,Hang Lin,Wei Dan,Lin Chen,Liangqun Rong,Shuiping Wang,Jin Fan,Chengming Xing,Haifeng Li,Weiming Yang,Changqing Wang,Yong Zhang,Xiaobo Li,Vitor Pereira,David Liebeskind,Raul G. Nogueira +87 more
TL;DR: There was no evidence of a difference in favourable outcomes of patients receiving endovascular therapy compared with those receiving standard medical therapy alone, and the trial was terminated early after 131 patients had been randomly assigned because of high crossover rate and poor recruitment.
Journal ArticleDOI
Mechanical recanalization in basilar artery occlusion: The ENDOSTROKE study
Oliver C. Singer,Joachim Berkefeld,Christian H. Nolte,Georg Bohner,Hans-Peter Haring,Johannes Trenkler,Klaus Gröschel,Wibke Müller-Forell,Kurt Niederkorn,Hannes Deutschmann,Tobias Neumann-Haefelin,Carina Hohmann,Matthias Bussmeyer,Anastasios Mpotsaris,Anett Stoll,Albrecht Bormann,Johannes Brenck,Marc Schlamann,Sebastian Jander,Bernd Turowski,Gabor C. Petzold,Horst Urbach,David S Liebeskind +22 more
TL;DR: A study was undertaken to evaluate clinical and procedural factors associated with outcome and recanalization in endovascular stroke treatment (EVT) of basilar artery (BA) occlusion.
Journal ArticleDOI
Endovascular Therapy for Stroke Due to Basilar-Artery Occlusion
Lucianne C.M. Langezaal,Erik J.R.J. van der Hoeven,Francisco Mont’Alverne,João José Freitas de Carvalho,Fabricio O. Lima,Diederik W.J. Dippel,Aad van der Lugt,Rob T.H. Lo,Jelis Boiten,Geert J. Lycklama à Nijeholt,Julie Staals,Wim H. van Zwam Md,Paul J. Nederkoorn,Charles B. L. M. Majoie,Johannes C. Gerber,Mikael Mazighi,Michel Piotin,Andrea Zini,Stefano Vallone,Jeannette Hofmeijer,Sheila Cristina Ouriques Martins,Christian Nolte,Kristina Szabo,Francisco Antunes Dias,Daniel Giansante Abud,Marieke J.H. Wermer,Michel J M Remmers,Hauke Schneider,Christina Rueckert,Karlijn F. de Laat,Albert J. Yoo,Pieter-Jan van Doormaal,Adriaan C.G.M. van Es,Bart J. Emmer,Patrik Michel,Volker Puetz,Heinrich J. Audebert,Octavio M. Pontes-Neto,Jan Albert Vos,L. Jaap Kappelle,Ale Algra,Wouter J. Schonewille +41 more
TL;DR: In this paper, the effectiveness of endovascular therapy in patients with stroke caused by basilar-artery occlusion has not been well studied, and the authors randomly assigned patients within 6 weeks.
Journal ArticleDOI
Assessment of Endovascular Treatment for Acute Basilar Artery Occlusion via a Nationwide Prospective Registry
Wenjie Zi,Zhongming Qiu,Deping Wu,Fengli Li,Hansheng Liu,Wenhua Liu,Wenguo Huang,Zhonghua Shi,Yongjie Bai,Zhensheng Liu,Li Wang,Shiquan Yang,Jie Pu,Changming Wen,Shouchun Wang,Qiyi Zhu,Wenhuo Chen,Congguo Yin,Min Lin,Li Qi,Yaoyi Zhong,Zhen Wang,Wenjun Wu,Huisheng Chen,Xiaoxi Yao,Feng Xiong,Guoyong Zeng,Zhiming Zhou,Zhilin Wu,Yue Wan,Huiyuan Peng,Bing Li,Xinping Hu,Hongbin Wen,Wangtao Zhong,Leyuan Wang,Ping Jin,Fuqiang Guo,Ju Han,Xinmin Fu,Zhibing Ai,Xiguang Tian,Xiaoya Feng,Bo Sun,Zhizhi Huang,Wei Li,Peiyang Zhou,Mingyi Tu,Xiangrong Sun,Hua Li,Wencheng He,Tao Qiu,Zhengzhou Yuan,Chengsong Yue,Jun Yang,Weidong Luo,Zili Gong,Jie Shuai,Raul G Nogueira,Qingwu Yang +59 more
TL;DR: Among patients with acute BAO, EVT administered within 24 hours of estimated occlusion time is associated with better functional outcomes and reduced mortality, and this nonrandomized cohort study was a nationwide prospective registry of consecutive patients presenting with an acute, symptomatic, radiologically confirmed BAO to 47 comprehensive stroke centers in China.
Journal ArticleDOI
Randomized controlled trials - a matter of design
Peter M. Spieth,Anne Sophie Kubasch,Ana Isabel Penzlin,Ben Min-Woo Illigens,Kristian Barlinn,Timo Siepmann +5 more
TL;DR: This review summarizes commonly applied designs and quality indicators of RCTs to provide guidance in interpreting and critically evaluating clinical research data and reflects on the principle of equipoise.
References
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Journal Article
Collateral circulation and outcome after basilar artery thrombolysis.
DeWitte T. Cross,Christopher J. Moran,Paul T. Akins,Edward E. Angtuaco,Colin P. Derdeyn,Michael N. Diringer +5 more
TL;DR: In symptomatic acute basilar artery thrombosis, neurologic outcome was better after intraarterial thrombolysis in patients who had collateral filling of the basilar arteries, except in cases of proximal basilar thromBosis.
Journal ArticleDOI
New England Medical Center Posterior Circulation Stroke Registry: I. Methods, Data Base, Distribution of Brain Lesions, Stroke Mechanisms, and Outcomes
Louis R. Caplan,C-S Chung,Robert J. Wityk,Thomas A. Glass,J Tapia,Ladislav Pazdera,H-M Chang,JF Dashe,Claudia Chaves,K Vemmos,Megan C. Leary,L. D. DeWitt,Pessin +12 more
TL;DR: Among 407 New England Medical Center Posterior Circulation Registry (NEMC-PCR) patients, 59% had strokes without transient ischemic attacks (TIAs), 24% had TIAs before strokes, and 16% had only posterior circulation TIAs.
Journal ArticleDOI
The Surgical Anatomy of the Perforating Branches of the Basilar Artery
TL;DR: Three groups of the perforators of the basilar artery were distinguished: the caudal, the middle, and the rostral, which varied in number from two to five and in diameter.
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.
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