Publication

Safety and Outcome of Intra-Arterial Treatment for Basilar Artery Occlusion

van Houwelingen, R. C., Luijckx, G-J., Mazuri, A., Bokkers, R. P. H., Eshghi, O. S. & Uyttenboogaart, M., 1-Oct-2016, In : Jama neurology. 73, 10, p. 1225-1230 6 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

van Houwelingen, R. C., Luijckx, G-J., Mazuri, A., Bokkers, R. P. H., Eshghi, O. S., & Uyttenboogaart, M. (2016). Safety and Outcome of Intra-Arterial Treatment for Basilar Artery Occlusion. Jama neurology, 73(10), 1225-1230. https://doi.org/10.1001/jamaneurol.2016.1408

Author

van Houwelingen, Reinier C. ; Luijckx, Gert-Jan ; Mazuri, Aryan ; Bokkers, Reinoud P. H. ; Eshghi, Omid S. ; Uyttenboogaart, Maarten. / Safety and Outcome of Intra-Arterial Treatment for Basilar Artery Occlusion. In: Jama neurology. 2016 ; Vol. 73, No. 10. pp. 1225-1230.

Harvard

van Houwelingen, RC, Luijckx, G-J, Mazuri, A, Bokkers, RPH, Eshghi, OS & Uyttenboogaart, M 2016, 'Safety and Outcome of Intra-Arterial Treatment for Basilar Artery Occlusion', Jama neurology, vol. 73, no. 10, pp. 1225-1230. https://doi.org/10.1001/jamaneurol.2016.1408

Standard

Safety and Outcome of Intra-Arterial Treatment for Basilar Artery Occlusion. / van Houwelingen, Reinier C.; Luijckx, Gert-Jan; Mazuri, Aryan; Bokkers, Reinoud P. H.; Eshghi, Omid S.; Uyttenboogaart, Maarten.

In: Jama neurology, Vol. 73, No. 10, 01.10.2016, p. 1225-1230.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

van Houwelingen RC, Luijckx G-J, Mazuri A, Bokkers RPH, Eshghi OS, Uyttenboogaart M. Safety and Outcome of Intra-Arterial Treatment for Basilar Artery Occlusion. Jama neurology. 2016 Oct 1;73(10):1225-1230. https://doi.org/10.1001/jamaneurol.2016.1408


BibTeX

@article{3436dfb8a218410ab26f8a63168aff53,
title = "Safety and Outcome of Intra-Arterial Treatment for Basilar Artery Occlusion",
abstract = "IMPORTANCE After the many positive results in thrombectomy trials in ischemic stroke of the anterior circulation, the question arises whether these positive results also apply to the patient with basilar artery occlusion (BAO).OBJECTIVE To report up-to-date outcome data of intra-arterial (IA) treatment in patients with BAO and to evaluate the influence of collateral circulation on outcome.DESIGN, SETTING, AND PARTICIPANTS Single-center retrospective case series of 38 consecutive patients with BAO who underwent IA treatment between 2006 and 2015 at a comprehensive stroke center.EXPOSURES Intra-arterial treatment by mechanical thrombectomy and/or IA thrombolysis.MAIN OUTCOMES AND MEASURES Adequate recanalization was defined as a score of 2b or 3 on the Thrombolysis in Cerebral Infarction score. Favorable outcome was defined as a modified Rankin Scale of 0 to 3 at first follow-up. Imaging data on the patency of the vertebral arteries and posterior communicating arteries, as well as the presence of cerebellar arterial anastomosis, were recorded and posttreatment imaging results were reviewed.RESULTS Of the 38 patients with BAO, mean (SD) age was 58 (16) years, and 21 (55{\%}) were male. Twenty-seven patients (71{\%}) were treated with intravenous thrombolysis before IA therapy. Mechanical thrombectomy was applied to 30 patients, and 7 patients received local urokinase without thrombectomy. The median National Institutes of Health Stroke Scale score was 21 (interquartile range [IQR], 15-32) points, and median time to IA treatment was 288 (IQR, 216-380) minutes. Adequate recanalization was achieved in 34 of 38 cases (89{\%}). Functional outcome was favorable in 19 (50{\%}) patients. No association between patent collateral circulation and favorable outcome was found. Symptomatic intracranial hemorrhage occurred in 2 patients (5{\%}).CONCLUSIONS AND RELEVANCE The proportion of patients reaching a favorable outcome in our study is comparable to the IA-treated group of the MR CLEAN trial and better than the results reported in the BASICS registry, suggesting that IA intervention in patients with BAO is an effective and safe treatment modality in daily clinical practice.",
keywords = "ACUTE ISCHEMIC-STROKE, ENDOVASCULAR TREATMENT, INTERNATIONAL-COOPERATION, INTRAVENOUS THROMBOLYSIS, RECANALIZATION, TRIAL, THERAPY, PREDICTORS, MANAGEMENT, BASICS",
author = "{van Houwelingen}, {Reinier C.} and Gert-Jan Luijckx and Aryan Mazuri and Bokkers, {Reinoud P. H.} and Eshghi, {Omid S.} and Maarten Uyttenboogaart",
year = "2016",
month = "10",
day = "1",
doi = "10.1001/jamaneurol.2016.1408",
language = "English",
volume = "73",
pages = "1225--1230",
journal = "Jama neurology",
issn = "2168-6149",
publisher = "AMER MEDICAL ASSOC",
number = "10",

}

RIS

TY - JOUR

T1 - Safety and Outcome of Intra-Arterial Treatment for Basilar Artery Occlusion

AU - van Houwelingen, Reinier C.

AU - Luijckx, Gert-Jan

AU - Mazuri, Aryan

AU - Bokkers, Reinoud P. H.

AU - Eshghi, Omid S.

AU - Uyttenboogaart, Maarten

PY - 2016/10/1

Y1 - 2016/10/1

N2 - IMPORTANCE After the many positive results in thrombectomy trials in ischemic stroke of the anterior circulation, the question arises whether these positive results also apply to the patient with basilar artery occlusion (BAO).OBJECTIVE To report up-to-date outcome data of intra-arterial (IA) treatment in patients with BAO and to evaluate the influence of collateral circulation on outcome.DESIGN, SETTING, AND PARTICIPANTS Single-center retrospective case series of 38 consecutive patients with BAO who underwent IA treatment between 2006 and 2015 at a comprehensive stroke center.EXPOSURES Intra-arterial treatment by mechanical thrombectomy and/or IA thrombolysis.MAIN OUTCOMES AND MEASURES Adequate recanalization was defined as a score of 2b or 3 on the Thrombolysis in Cerebral Infarction score. Favorable outcome was defined as a modified Rankin Scale of 0 to 3 at first follow-up. Imaging data on the patency of the vertebral arteries and posterior communicating arteries, as well as the presence of cerebellar arterial anastomosis, were recorded and posttreatment imaging results were reviewed.RESULTS Of the 38 patients with BAO, mean (SD) age was 58 (16) years, and 21 (55%) were male. Twenty-seven patients (71%) were treated with intravenous thrombolysis before IA therapy. Mechanical thrombectomy was applied to 30 patients, and 7 patients received local urokinase without thrombectomy. The median National Institutes of Health Stroke Scale score was 21 (interquartile range [IQR], 15-32) points, and median time to IA treatment was 288 (IQR, 216-380) minutes. Adequate recanalization was achieved in 34 of 38 cases (89%). Functional outcome was favorable in 19 (50%) patients. No association between patent collateral circulation and favorable outcome was found. Symptomatic intracranial hemorrhage occurred in 2 patients (5%).CONCLUSIONS AND RELEVANCE The proportion of patients reaching a favorable outcome in our study is comparable to the IA-treated group of the MR CLEAN trial and better than the results reported in the BASICS registry, suggesting that IA intervention in patients with BAO is an effective and safe treatment modality in daily clinical practice.

AB - IMPORTANCE After the many positive results in thrombectomy trials in ischemic stroke of the anterior circulation, the question arises whether these positive results also apply to the patient with basilar artery occlusion (BAO).OBJECTIVE To report up-to-date outcome data of intra-arterial (IA) treatment in patients with BAO and to evaluate the influence of collateral circulation on outcome.DESIGN, SETTING, AND PARTICIPANTS Single-center retrospective case series of 38 consecutive patients with BAO who underwent IA treatment between 2006 and 2015 at a comprehensive stroke center.EXPOSURES Intra-arterial treatment by mechanical thrombectomy and/or IA thrombolysis.MAIN OUTCOMES AND MEASURES Adequate recanalization was defined as a score of 2b or 3 on the Thrombolysis in Cerebral Infarction score. Favorable outcome was defined as a modified Rankin Scale of 0 to 3 at first follow-up. Imaging data on the patency of the vertebral arteries and posterior communicating arteries, as well as the presence of cerebellar arterial anastomosis, were recorded and posttreatment imaging results were reviewed.RESULTS Of the 38 patients with BAO, mean (SD) age was 58 (16) years, and 21 (55%) were male. Twenty-seven patients (71%) were treated with intravenous thrombolysis before IA therapy. Mechanical thrombectomy was applied to 30 patients, and 7 patients received local urokinase without thrombectomy. The median National Institutes of Health Stroke Scale score was 21 (interquartile range [IQR], 15-32) points, and median time to IA treatment was 288 (IQR, 216-380) minutes. Adequate recanalization was achieved in 34 of 38 cases (89%). Functional outcome was favorable in 19 (50%) patients. No association between patent collateral circulation and favorable outcome was found. Symptomatic intracranial hemorrhage occurred in 2 patients (5%).CONCLUSIONS AND RELEVANCE The proportion of patients reaching a favorable outcome in our study is comparable to the IA-treated group of the MR CLEAN trial and better than the results reported in the BASICS registry, suggesting that IA intervention in patients with BAO is an effective and safe treatment modality in daily clinical practice.

KW - ACUTE ISCHEMIC-STROKE

KW - ENDOVASCULAR TREATMENT

KW - INTERNATIONAL-COOPERATION

KW - INTRAVENOUS THROMBOLYSIS

KW - RECANALIZATION

KW - TRIAL

KW - THERAPY

KW - PREDICTORS

KW - MANAGEMENT

KW - BASICS

U2 - 10.1001/jamaneurol.2016.1408

DO - 10.1001/jamaneurol.2016.1408

M3 - Article

C2 - 27532477

VL - 73

SP - 1225

EP - 1230

JO - Jama neurology

JF - Jama neurology

SN - 2168-6149

IS - 10

ER -

ID: 36006758