The Basilar Artery International Cooperation Study (BASICS): study protocol for a randomised controlled trial

Hoeven, Erik Jrj van der; Schonewille, Wouter J.; Vos, Jan Albert; Algra, Ale; Audebert, Heinrich J.; Berge, Eivind; Ciccone, Alfonso; Mazighi, Mikaël; Michel, Patrik; Muir, Keith W.; Obach, Vı́ctor; Puetz, Volker; Wijman, Cristanne Ac; Zini, Andrea; Kappelle, Jaap

doi:10.1186/1745-6215-14-200

Cited by 137 publications

(109 citation statements)

References 29 publications

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“…Currently, there is an ongoing prospective randomized BaSiCS trial that is devoted to the issues mentioned above, comprising evaluation of different treatment approaches. 31 …”

Section: Discussionmentioning

confidence: 99%

Outcome Predictors in Acute Basilar Artery Occlusion

Dorňák¹,

Herzig²,

Školoudík³

et al. 2014

Can. J. Neurol. Sci.

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368Basilar artery occlusion (Bao) is an infrequent form of acute ischemic stroke (aiS). this particular type of stroke occurs in approximately 1% of all-cause cases and is reported in approximately 8% of patients with symptomatic vertebrobasilar territory ischemia.1,2 Basilar artery occlusion symptoms are heterogeneous and may vary from mild neurological deficits consisting of visual, oculomotor, and behavioral abnormalities to a locked-in state or coma.3,4 however, severe and persistent ABSTRACT: Objective: to identify predictors of good outcome in acute basilar artery occlusion (Bao). Background: acute ischemic stroke (aiS) caused by Bao is often associated with a severe and persistent neurological deficit and a high mortality rate. Methods: the set consisted of 70 consecutive aiS patients (51 males; mean age 64.5±14.5 years) with Bao. the role of the following factors was assessed: baseline characteristics, stroke risk factors, pre-event antithrombotic treatment, neurological deficit at time of treatment, estimated time to therapy procedure initiation, treatment method, recanalization rate, change in neurological deficit, post-treatment imaging findings. 30-and 90-day outcome was assessed using the modified rankin scale with a good outcome defined as a score of 0-3. Results: the following statistically significant differences were found between patients with good versus poor outcomes: mean age (54 RÉSUMÉ: Facteurs de prédiction du résultat dans l'occlusion aiguë de l'artère basilaire. Objectif : le but de l'étude était d'identifier les facteurs de prédiction d'une issue favorable dans l'occlusion aiguë de l'artère basilaire (oaB). Contexte : l'accident vasculaire cérébral ischémique aigu (aVCia) causé par une oaB est souvent associé à un déficit neurologique sévère et persistant et à un taux de mortalité élevé. Méthodes : l'étude a porté sur 70 patients consécutifs atteints d'une oaB, dont 51 étaient des hommes et dont l'âge moyen était de 64,5 ± 14,5 ans. nous avons étudié le rôle des facteurs suivants : les caractéristiques des patients à l'évaluation initiale, les facteurs de risque d'un aVC, le traitement antithrombotique avant l'oaB, le déficit neurologique au moment du traitement, le temps écoulé entre le début des symptômes et le début du traitement, le mode de traitement, le taux de recanalisation, les changements constatés concernant le déficit neurologique, les constatations à l'imagerie après le traitement. nous avons évalué les résultats à deux reprises, soit 30 jours et 90 jours après l'événement, au moyen de l'échelle modifiée de rankin, une issue favorable étant définie comme un score de 0 à 3. Résultats : les différences suivantes étaient significatives au point de vue statistique entre les patients dont l'issue était bonne par rapport à ceux dont l'issue était médiocre : l'âge moyen des patients (54,2 vs. 68,9 ans ; p = 0,0001), la présence d'hypertension artérielle (52,4% vs. 83,7% ; p = 0,015), de diabète (9,5% vs. 55,1% ; p = 0,0004) et d'un aVC sévère (14,3% vs. 65,3%; p = 0,0002), le déf...

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“…Currently, there is an ongoing prospective randomized BaSiCS trial that is devoted to the issues mentioned above, comprising evaluation of different treatment approaches. 31 …”

Section: Discussionmentioning

confidence: 99%

Outcome Predictors in Acute Basilar Artery Occlusion

Dorňák¹,

Herzig²,

Školoudík³

et al. 2014

Can. J. Neurol. Sci.

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“…The posterior circulation must also be examined in greater detail with regard to the use of modern stent retrievers. A study examining this question has already been initiated [46]. 5.…”

Section: Review 260mentioning

confidence: 99%

Interventional Ischemic Stroke Treatment – A (R)evolution

Friedrich

Gawlitza

Fahnert

et al. 2015

Fortschr Röntgenstr

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In recent years ischemic stroke caused by an intracranial vessel occlusion has become a treatable disease. Over decades intravenous thrombolysis by recombinant tissue plasminogen activator was the only accepted causal treatment of ischemic stroke supported by the results of randomized, controlled trials. However, there has been continuous development of endovascular treatment strategies over recent years. Today there are 5 prospective, randomized multicenter studies showing the highly significant superiority of endovascular, mechanical recanalization over intravenous thrombolysis in cases of acute occlusion of an intracranial vessel of the anterior circulation. In all those studies endovascular treatment resulted in a tremendous increase in functional independence together with a reduction of mortality without a significant increase in complications. This article reviews the developments resulting in the current data and gives an overview of the present studies focusing on endovascular stroke treatment. Key Points: ??In the last 20 years ischemic stroke due to an main stem occlusion has become a potentially treatable disease. ??Several in 2015 published randomized Multicentener trials could prove the superiority of endovascular, mechanical recanalization over i.v. thrombolysis alone. ?? Acute ischemic stroke due to a main stem occlusion should be treated with swift endovascular stent-retriever based recanalization in specialized neurovascular centers. Citation Format: ??Friedrich B, Gawlitza M, Fahnert J et?al. Interventional Ischemic Stroke Treatment ? A (R)evolution. Fortschr R?ntgenstr 2016; 188: 1???9

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“…Identifying the acute ischemic stroke patients with symptomatic vascular occlusions helps distinguish the most high-risk patients and has the potential to lead to more rapid institution of treatment. 7,8,13 Another explanation for pial vessel asymmetry without detection of occlusion is early recanalization without reperfusion. Identifying these patients is relevant because reperfusion has been shown to be a stronger predictor of good clinical and imaging outcome compared to recanalization.…”

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confidence: 99%

Multiphase CT angiography increases detection of anterior circulation intracranial occlusion

Zerna

Assis

et al. 2016

Neurology

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Objective: To evaluate whether the use of multiphase CT angiography (CTA) improves interrater agreement for intracranial occlusion detection between stroke neurology trainees and an expert neuroradiologist.Methods: A neuroradiologist and 2 stroke neurology fellows independently reviewed 100 prospectively collected single-phase and multiphase CTA scans from acute ischemic stroke patients with mild symptoms (NIH Stroke Scale score #5). The presence and location of a vascular occlusion(s) were documented. Interrater agreement single-and multiphase CTA was quantified using unweighted k statistics. We assessed for any occlusions, anterior vs posterior occlusions, and pial vessel asymmetry.Results: Using multiphase CTA, the neuroradiologist detected 50 scans with anterior circulation occlusions and 15 scans with posterior circulation occlusions. Median reading time was 2 minutes per scan. Median reading time for the neurologists was 3 minutes per multiphase CTA scan. Interrater agreement was fair between the 2 neurologists and neuroradiologist when using single-phase CTA (k 5 0.45 and 0.32). Agreement improved minimally when stratified by anterior vs posterior circulation. When using multiphase CTA, agreement was high for detection of occlusion or asymmetry of pial vessels in the anterior circulation (k 5 0.80 and 0.84).Conclusions: Multiphase CTA improves diagnostic accuracy in minor ischemic stroke for detection of anterior circulation intracranial occlusion. Classification of evidence:This study provides Class II evidence that multiphase CTA, compared to single-phase CTA, improves the interrater agreement between stroke neurology trainees and an expert neuroradiologist for detecting anterior circulation intracranial vascular occlusion in patients with minor acute ischemic strokes.

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The Basilar Artery International Cooperation Study (BASICS): study protocol for a randomised controlled trial

Cited by 137 publications

References 29 publications

Outcome Predictors in Acute Basilar Artery Occlusion

Outcome Predictors in Acute Basilar Artery Occlusion

Interventional Ischemic Stroke Treatment – A (R)evolution

Multiphase CT angiography increases detection of anterior circulation intracranial occlusion

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