Abstract Details

Title Endovascular Treatment Versus Medical Management for Basilar Artery Occlusion with Low-to-Moderate Symptoms (National Institutes of Health Stroke Scale<10)

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S22 - Innovations in Cerebrovascular Therapy (4:54 PM-5:06 PM)

Poster/Presentation
Number 008

Background Patients with acute basilar artery occlusion (BAO) and low-to-moderate symptoms (National Institutes of Health Stroke Scale [NIHSS]<10) are poorly represented in thrombectomy trials. Our objective is to compare thrombectomy and best medical management (BMT) in this population.

Objective

The purpose of this study was to use data from the large, multicenter Endovascular Treatment in Ischemic Stroke [ETIS] registry to compare 3-month functional outcomes in patients with an acute BAO and low-to-moderate symptoms (NIHSS<10) treated with EVT versus those treated with BMT during the same time period.

Design/Methods We compared data of all consecutive patients presenting with an initial NIHSS<10 and acute symptomatic BAO included in two registries. The main outcome was the proportion of patients achieving a 3-months favorable outcome (mRS 0-2 or equal to the pre-stroke value). Secondary outcomes included the proportion of patients with an excellent outcome (mRS 0-1 or equal to pre-stroke value), overall mRs distribution (shift analysis) and mortality. Effect sizes for thrombectomy versus BMT alone were calculated using binary or ordinal logistic regression model before after considering confounders using the inverse probability of treatment weighting (IPTW) propensity score method.

Results 127 patients were included: 64 patients treated with thrombectomy (mean±SD age: 63.4±16.1) and 63 with BMT (mean±SD age: 69.0±14.3). There was no significant difference between groups for the rate of 3 month-favorable outcome or mortality. After propensity-score adjustment, thrombectomy was associated with a significantly higher chance of excellent outcome at 3 months (mRS 0-1 or equal to pre-stroke value) (adjusted OR, 2.68; 95%CI, 1.04 to 6.90; P=0.041).

Conclusions Our study suggests that thrombectomy in patients with low-to-moderate symptoms (NIHSS<10) due to BAO does not improve the rate of favorable outcome but could lead to a higher chance of excellent outcome at 3 months.

Authors/Disclosures
Laurence Poirier, MD PRESENTER	Dr. Poirier has nothing to disclose.
Cyril Dargazanli, MD, PhD	Dr. Dargazanli has nothing to disclose.
Isabelle Mourand	No disclosure on file
julien labreuche, MSc	Mr. labreuche has nothing to disclose.
David Weisenburger, MD	Dr. Weisenburger has nothing to disclose.
Sebastien Richard, PhD	An immediate family member of Prof. Richard has received personal compensation in the range of $0-$499 for serving as a Consultant for ACTICOR. The institution of Prof. Richard has received research support from French Health Ministery.
Célina Ducroux (The Ottawa Hospital)	Célina Ducroux has nothing to disclose.
Gaultier Marnat, MD	Dr. Marnat has nothing to disclose.
Romain Bourcier, MD, PhD	Prof. bourcier has received personal compensation in the range of $500-$4,999 for serving as a Consultant for johnson & johnson.
Maud Guillen, MD	Dr. Guillen has nothing to disclose.
Francois EUGENE, MD	Dr. EUGENE has nothing to disclose.
Gregory B. Walker, MD (U of British Columbia)	Dr. Walker has nothing to disclose.
Ronda Lun, MD	Dr. Lun has nothing to disclose.
Dariush Dowlatshahi, MD (University of Ottawa)	Dr. Dowlatshahi has nothing to disclose.
Michel C. Shamy, MD (Ottawa Hospital - Civic Campus)	Dr. Shamy has nothing to disclose.
Bertrand Lapergue	Bertrand Lapergue has received personal compensation in the range of $500-$4,999 for serving as a Consultant for MICROVENTION .
Adrien Guenego, MD	Dr. guenego has received personal compensation in the range of $500-$4,999 for serving as a Consultant for phenox.
Robert Fahed (The Ottawa Hospital)	Robert Fahed has nothing to disclose.

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