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Early and late basilar artery thrombectomy time window outcomes
Journal article   Open access   Peer reviewed

Early and late basilar artery thrombectomy time window outcomes

Adam T. Mierzwa, Rahul Rao, Sami Al Kasab, Ashley Nelson, Santiago Ortega-Gutierrez, Juan Vivanco-Suarez, Mudassir Farooqui, Ashutosh P. Jadhav, Shashvat Desai, Gabor Toth, …
Frontiers in neurology, Vol.15, 1352310
01/26/2024
DOI: 10.3389/fneur.2024.1352310
PMCID: PMC10858612
PMID: 38343711
url
https://doi.org/10.3389/fneur.2024.1352310View
Published (Version of record) Open Access

Abstract

Importance Stroke-to-recanalization time is a strong predictor of outcomes in anterior circulation large-vessel occlusion (LVO). The authors aimed to evaluate functional outcomes in early (<6 h) vs. late (6–24 h) time windows for thrombectomy-treated basilar artery occlusions. Methods Patients were derived from the Posterior Circulation Ischemic Stroke Evaluation: Analyzing Radiographic and Intra-procedural Predictors of Mechanical Thrombectomy (PC-SEARCH) Registry and retrospectively analyzed early and late basilar artery thrombectomy time windows cohorts. Patients were dichotomized based on the last known well and correlated to 90-day functional outcomes (mRS 0–3). A multiple logistic regression analysis was performed. Results A total of 405 patients were included in this study: 216 and 189 patients in the early and late time windows, respectively. Baseline demographic, stroke, radiographic, and intraprocedural characteristics were similar between the groups. A total of 99 (46%) and 79 (42%) patients in the early and late time windows, respectively, achieved favorable functional outcomes at 90 days ( p = 0.41), and multiple logistic regression analysis did not reveal differences between cohorts (OR: 0.74; 95% CI: 0.46–1.19; p = 0.22). Symptomatic hemorrhage (7% vs. 5%; p = 0.69) and neurological complications (8% vs. 9%; p = 0.83) were similar between the groups; however, hospital complications were more common in the early time window cohort (22% vs. 13%; p = 0.01). Conclusion The early and late thrombectomy time windows can achieve similar rates of 90-day favorable functional outcomes. However, timely thrombectomy influences the likelihood of achieving excellent functional outcomes (mRS ≤ 2) within the early time window.

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