Early and late basilar artery thrombectomy time window outcomes

oleh: Adam T. Mierzwa, Adam T. Mierzwa, Rahul Rao, Rahul Rao, Sami Al Kasab, Ashley Nelson, Santiago Ortega-Gutierrez, Juan Vivanco-Suarez, Mudassir Farooqui, Ashutosh P. Jadhav, Shashvat Desai, Gabor Toth, Anas Alrohimi, Thanh N. Nguyen, Piers Klein, Mohamad Abdalkader, Hisham Salahuddin, Aditya Pandey, Zachary Wilseck, Sravanthi Koduri, Nirav Vora, Nameer Aladamat, Khaled Gharaibeh, Ehad Afreen, Ehad Afreen, Syed Zaidi, Syed Zaidi, Mouhammad Jumaa, Mouhammad Jumaa

Format: Article
Diterbitkan: Frontiers Media S.A. 2024-01-01

Deskripsi

ImportanceStroke-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.MethodsPatients 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.ResultsA 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).ConclusionThe 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.