Citations 1
Abstract TMP88: Impact of Tandem Vertebrobasilar Occlusion on Outcome of Mechanical Thrombectomy for Basilar Artery Occlusion
Nawabi, Noah, Uchida, Kazutaka , Maier, Ilko , Kasab, Sami Al , Jabbour, Pascal , Kim, Joon‐Tae , Quintero, Stacey C, Rai, Ansaar , Starke, Robert M. , Psychogios, Marios, Grossberg, Jonathan A , Tanweer, Omar , Polifka, Adam , Park, Min S. , Brinjikji, Waleed , Moss, Mark, Dumont, Travis M., Williamson, Richard , Navía, Pedro , Kan, Peter , Chowdhry, Shakeel , Ezzeldin, Mohamad , Spiotta, Alejandro M , Navia, Pedro , Cunningham, Conor M. , Elawady, Sameh Samir , Matsukawa, Hidetoshi , Sowlat, Mohammad‐Mahdi , Zandpazandi, Sara , Orscelik, Atakan , Jabbour, Pascal , Psychogios, Marios‐Nikos , Shaban, Amir , Arthur, Adam Stephen , Yoshimura, Shinichi , Cuellar, Hugo , Alawieh, Ali , Romano, Daniele G., Mascitelli, Justin R , Fragata, Isabel , Osbun, Joshua W , Crosa, Roberto , Matouk, Charles , Levitt, Michael R. , Leacy, Reade De
Stroke | February 1, 2024 | Volume: 55 | Issue: Suppl_1 | Pages: No page available
Introduction: The efficacy of mechanical thrombectomy (MT) for tandem vertebrobasilar occlusion (tVBO) is not well established in patients with basilar artery occlusion (BAO). Objective: To investigate the treatment outcomes of MT in tVBO. Method: This international, multicenter, retrospective cohort included patients with MT for tVBO and isolated BAO from 2013 to 2023. The primary outcome was the 90-day modified Rankin Scale (mRS) score 0-2. Secondary outcomes included complete recanalization (modified Thrombolysis in Cerebral Ischemia [mTICI] ≥ 2C) and 90-day mortality rate. These outcomes were compared between tVBO and isolated BAO groups. Adjustment factors were age, sex, admission National Institutes of Health Stroke Scale (NIHSS), pre-morbid mRS, onset to groin duration, and intravenous tissue plasminogen activator. Results: Among 10,229 patients, 689 had BAO. Of those, 61 (9.7%) had a tVBO. Median age was 61 [IQR 53-74] years and 29 (47.5%) patients were female. Compared to isolated BAO, tVBO group had lower age (61 [53-74] versus 68 [58-79], P<0.001) and lower admission NIHSS (15 [7 - 22] versus 17 [9-26], P≤0.05). There was no significant difference in the rate of complete recanalization between the two groups (adjusted odds ratio [aOR]: 0.83; 95% CI: 0.39-1.79; P=0.60) However, the tVBO group had significantly lower odds of a favorable outcome compared to the isolated BAO group (aOR: 0.35; 95% CI: 0.13-0.83; P=0.023) and higher odds of 90-day mortality (aOR: 3.51; 95% CI: 1.59-7.85; P=0.002). Binary regression analysis revealed that age (OR 0.98; 95% CI 0.96 - 1.00; P=0.019), admission NIHSS (OR 0.90; 95% CI 0.87-0.93; P<0.001), premorbid mRS (OR 0.71; 95% CI 0.53-0.93; P=0.016), successful recanalization (OR 2.94; 95% CI 1.71-5.15; P<0.001), and tVBO (OR 0.33; 95% CI 0.11-0.86; P=0.031) were significant predictors of 90-day favorable outcome. Conclusion: tVBO was associated with poor outcomes. Further efforts should be aimed at improving outcomes for this subpopulation.