Thrombolytic Therapy of Acute Basilar Artery Occlusion

Brandt, Tobias; Kummer, Rüdiger von; Müller-Küppers, M; Hacke, Werner

doi:10.1161/01.str.27.5.875

Cited by 419 publications

(177 citation statements)

References 31 publications

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“…2,8,9 Recanalization rates ranged from 40% to 100%, on average Ϸ50% to 60% in line with the results from the Prolyse in Acute Cerebral Thromboembolism II (PROACT II) trial. 10 Survival in patients without recanalization ranged from 0% to 20% as opposed to 40% to 80% in those with recanalization.…”

Section: B Asilar Artery Thrombosis (Bat) Is a Rare But Mostsupporting

confidence: 66%

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Intra-arterial Thrombolysis

Prestigiacomo¹,

Duffis²,

Gandhi³

2015

Surgical Endovascular Neuroradiology

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Section: B Asilar Artery Thrombosis (Bat) Is a Rare But Mostsupporting

confidence: 66%

“…6,7 Most studies suffered from small numbers: Ͻ10 patients with only a few in the range of 40 to 50 patients. 2,8,9 All had an open, retrospective or partly prospective design with differing treatment regimens, mostly IA thrombolytic drugs formally rendering level III evidence at best.…”

Section: B Asilar Artery Thrombosis (Bat) Is a Rare But Mostmentioning

confidence: 99%

Intra-arterial Thrombolysis

Prestigiacomo¹,

Duffis²,

Gandhi³

2015

Surgical Endovascular Neuroradiology

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“…[13][14][15][16][17][18] The largest adult series, the Basilar Artery International Cooperation Study (BASICS), reported 619 patients with BAO of whom over half (328 of 619) received intra-arterial tPA and other mechanical endovascular treatments. Overall mortality was 39%, and 31% survived with an mRankin scale score of 4 or 5 for a 70% frequency of 'poor outcome' by the authors' definition.…”

Section: Discussionmentioning

confidence: 99%

Basilar artery strokes in children: good outcomes with conservative medical treatment

Lagman-Bartolome

Pontigon

Moharir

et al. 2013

Develop Med Child Neuro

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Aim To describe outcomes and outcome predictors in childhood basilar artery stroke (BAS). Method We prospectively enrolled children with BAS with or without basilar artery occlusion (BAO) in the Toronto Children's Stroke Registry from 1992 to 2009. We assessed presenting features and outcomes including Pediatric Stroke Outcome Measure scores. Results Among 578 children with acute arterial ischemic stroke, 27 had BAS (4.6% including neonates, 6% excluding neonates). Twenty‐four (14 males, 10 females) children met study criteria (mean age at stroke was 8y 10mo; range 0–17y). Eleven children had BAO. Aspirin or anticoagulation was given to 15 children. None received tissue plasminogen activator or endovascular treatments. At mean follow‐up (3y 2mo, range 1mo–11y 8mo), 12 had a ‘good outcome’ (seven normal, five insignificant deficit) and 12 had ‘poor outcome’ (10 moderate or severe deficit, two acute deaths). Larger infarct size (≥50% of axial brainstem diameter) independently predicted poor outcome (p=0.02; odds ratio 21.2, 95% confidence interval 1.6–274.9) but not BAO, altered level of consciousness, or age. Interpretation Compared with adults, in childhood BAS death is rare and survivors frequently have good outcomes. Aggressive endovascular interventions may not be justifiable in this population.

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“…A nonrandomized trial compared patients with and without hyperdensity of the MCA territory at baseline CT who were then given intravenous or intra-arterial rt-PA. Intravenous rt-PA therapy was associated with less favorable outcomes in patients with hyperdense MCA sign as compared to patients without it 33 . Although observational studies of urokinase and rt-PA for intra-arterial treatment of basilar artery occlusion have shown encouraging results, there are no randomized clinical trials with adequate statistical power [34][35][36] . A systematic review found no significant differences between intravenous or intra-arterial thrombolysis for basilar artery occlusion 37 .…”

Section: Protocol For Intra-arterial Thrombolysismentioning

confidence: 99%