Christian Maegerlein (Germany)
Klinikum rechts der Isar, Technical University of Munich, School of Medicine Department of Diagnostic and Interventional NeuroradiologyAuthor Of 1 Presentation
MECHANICAL THROMBECTOMY FOR BASILAR ARTERY OCCLUSION STROKE: ANALYSIS OF THE GERMAN STROKE REGISTRY-ENDOVASCULAR TREATMENT (GSR-ET)
Abstract
Background and Aims
Stroke due to basilar artery occlusion (BAO) causes the most severe strokes with poor prognosis. Data regarding efficacy of mechanical thrombectomy (MT) in BAO are sparse.
Methods
Patients enrolled between 06/2015 and 12/2019 in the German Stroke Registry-Endovascular Treatment (GSR-ET) were analyzed. The GSR-ET is an independent, prospective, multicenter, observational registry with 25 participating stroke centers in Germany enrolling patients treated with MT. Primary outcomes were successful reperfusion (mTICI score of 2b-3) and good functional outcome at 3-months (mRS of 0-2).
Results
640 (9.6%) of the 6635 patients in the GSR were strokes due to BAO. Successful reperfusion was observed in 86.6%. At 3 months follow-up, 31% of patients showed a good functional outcome, mortality was 39%. Analysis of mTICI3 vs. mTICI2b showed considerable better outcomes (good outcome in 38.9% vs. 24.4% p=0.005, see Figure 1). Strongest predictor for good functional outcome were IVT treatment (OR 3.04, 95% CI 1.76-5.23) and successful reperfusion (OR 4.92, 95% CI 1.15-21.11), while the effect of the time between symptom onset and start of reperfusion seems to be low (see Figure 2).
Conclusions
Acute reperfusion strategies of BAO are common in daily practice and can be performed safely with high rates of successful reperfusion. Our data suggest that successful, and especially complete reperfusion predicts good outcome, while the time since symptom onset has a low impact. That reinforces the importance of reperfusion success in acute BAO. Future clinical trials should address acute reperfusion strategies of BAO patients.