Akademik Veri Yönetim Sistemi
TURK SEREBROVASKULER HASTALIKLAR DERGISI, cilt.30, sa.1, ss.13-21, 2024 (Hakemli Dergi)
thrombectomy outcomes in stroke patients with basilar occlusion who have a high risk of mortality. METHODS: The data of acute stroke patients who applied to our hospital between January 2018 and June 2022, who had basilar artery occlusion and underwent mechanical thrombectomy, were retrospectively analysed and included in the study. Patients' demographic characteristics, comorbidities, medications, blood pressure at admission to the emergency room, NIHSS, radiological imaging results, symptom onset time, intravenous recombinant tissue plasminogen activator (IV tPA) treatment and contraindications were examined. The posterior circulation Alberta stroke program early computed tomography score (pc-ASPECT) and the basilar artery on computed tomography angiography (BATMAN) scores were evaluated by examining brain computed tomography (CT) and CT angiography results. The results of the patients who received combined IV tPA and endovascular thrombectomy (EVT) were compared with the patients who underwent EVT alone. Post-procedure recanalization results, EVT complications, functional outcomes at discharge and 3-month outcomes were compared between the two groups. Clinical outcome was determined using the modified Rankin scale (mRS). Those with mRS 0-2 were included in the good clinical outcome group, whereas those with mRS 3-6 were included in the poor clinical outcome group. RESULTS: The results of the patient group treated with combined IVtPA and EVT were compared with the group treated with EVT alone.The rate of patients who achieved complete recanalization after the procedure was 53.3% in the direct EVT group, compared to 42.9% in the combined group. Intracranial bleeding after EVT was13.3% in the direct EVT group,while it was7.1% in the combined group. After EVT, reocclusion was observed in 3(56.7%)patients in the direct EVT group and in2(14.3%) patients in the combined group. MRS was 31.1%in the0-2 direct EVT group and 35.7%in the combined group.While mRS3-6 was 68.9%in the directEVT group,it was 64.3%in the combined group.There was no statistically significant difference between the groups. Binary logistic analysis showed that advanced age increased the risk of poor outcome.Those with type3 aortic arch increased the risk of poor outcomes 10.5 times compared to those with type1. DISCUSSION AND CONCLUSION: There was no statistically significant effect of the treatment type on mRS in the patient groups who received direct EVTand IVtPA plusEVT combination.Advanced age was found to be directly associated with poor clinical outcome. Keywords: Basilar artery occlusion, direct EVT, bridging therapy