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 ArticleDOI
Results of a multicentre, randomised controlled trial of intra-arterial urokinase in the treatment of acute posterior circulation ischaemic stroke.
Malcolm R. Macleod,Stephen M. Davis,Stephen M. Davis,Peter Mitchell,Richard P. Gerraty,Gregory J Fitt,Graeme J. Hankey,EdwardG. Stewart-Wynne,D Rosen,John J McNeil,Christopher F. Bladin,Brian R. Chambers,Geoffrey K. Herkes,D Young,Geoffrey A. Donnan +14 more
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Journal ArticleDOI
Clinical features of proven basilar artery occlusion.
TL;DR: The most common prodromal symptoms were vertigo, nausea, and headache, which occurred during the 2 weeks before the stroke, and an embolic origin of basilar artery occlusion from an arteriosclerotic vertebral artery lesion was assumed.
Journal ArticleDOI
Clinical and radiological predictors of recanalisation and outcome of 40 patients with acute basilar artery occlusion treated with intra-arterial thrombolysis
Marcel Arnold,Krassen Nedeltchev,Gerhard Schroth,R W Baumgartner,Luca Remonda,Thomas J. Loher,Frank Stepper,Matthias Sturzenegger,B. Schuknecht,Heinrich Mattle +9 more
TL;DR: Low baseline NIHSS on admission and recanalisation of basilar artery occlusions predict a favourable outcome after intra-arterial thrombolysis, and early initiation of IAT and the presence of a hyperdense basilar arteries sign on CT were associated with a higher likelihood of recanAlisation.
Journal ArticleDOI
Basilar Artery Occlusive Disease in the New England Medical Center Posterior Circulation Registry
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Journal ArticleDOI
Outcome in patients with basilar artery occlusion treated conventionally
TL;DR: Conventional treatment of symptomatic basilar artery occlusion is associated with a poor outcome in almost 80% of patients, which emphasises the importance of the search for a more effective treatment approach.
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