Multimodal reperfusion therapy in patients with acute basilar artery occlusion

Neurosurgery. 2009 Sep;65(3):548-52; discussion 552-3. doi: 10.1227/01.NEU.0000350862.35963.49.


Objective: Multimodal reperfusion therapy (MMRT) has been advocated for the treatment of acute basilar artery occlusion (ABAO). We aimed to identify prognostic factors in patients with ABAO who underwent MMRT.

Methods: Clinical and radiological data from consecutive ABAO patients were analyzed. All patients underwent MMRT on an emergency basis. Stroke subtypes were categorized according to TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria. Good outcome was defined as a modified Rankin Scale score of 3 or less and poor outcome as a score of 4 or more at 30 days poststroke.

Results: Twenty-four patients were included (18 men, 6 women) with a mean age of 54.7 years (age range, 26-70 years). Six patients died (25%), and 8 of the surviving 18 patients (44%) achieved a modified Rankin Scale score of 3 or less at 30 days. We could not identify any clinical or radiological variables that were associated with a greater likelihood of good or poor outcome at 30 days other than the presence of good collateral circulation, which was associated with better outcome on univariate analysis.

Conclusion: MMRT resulted in high survival and good outcome rates. We could not identify prognostic factors in patients with ABAO treated with MMRT other than the presence of collateral flow. Our results imply that patients should not be excluded from treatment based on clinical or radiological parameters, and that all patients with ABAO should be given the chance to benefit from therapy.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Arterial Occlusive Diseases / diagnosis*
  • Arterial Occlusive Diseases / therapy*
  • Basilar Artery / pathology*
  • Female
  • Humans
  • Logistic Models
  • Magnetic Resonance Angiography / methods
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Neurologic Examination / methods
  • Reperfusion / methods*
  • Time Factors
  • Tomography, X-Ray Computed / methods