Staged Escalation Therapy in Acute Basilar Artery Occlusion

• DOI: 10.1161/strokeaha.107.505123
• Publication Date: 2008-03-07T02:25:35Z
• Authors: Thomas Pfefferkorn; Thomas E. Mayer; Christian Opherk; Nils Peters; Andreas Straube; Hans-Walter Pfister; Markus Holtmannsp...; Stefanie Müller-...; Martin Wiesmann; Martin Dichgans
• Keywords: Stroke

The prognosis of acute basilar artery occlusion (BAO) is poor if early recanalization not achieved. Recanalization strategies include intravenous thrombolysis (IVT) and intra-arterial thrombolysis, as well endovascular mechanical thrombectomy (EMT). combination IVT with consecutive on-demand EMT may allow for treatment initiation high rates but has never been systematically tested in patients BAO.Starting January 2006, we treated all eligible BAO admitted to our academic stroke center or one cooperating community hospitals after a standardized protocol combining EMT. Inclusion criteria were: (1) presence predefined symptoms clearly suggestive BAO; (2) exclusion intracerebral hemorrhage on CT scan; (3) evidence angiography; (4) start therapy within 6 hours symptom onset; (5) no contraindications IVT. If angiography showed persistent IVT, was performed.Since 16 have treated. All received IVT; 7 them, became necessary because BAO. Final achieved 15 patients. Three months therapy, 12 were still alive; them had good outcome (modified Rankin score <or=2).Our data suggest that the feasible, allows treatment, provides excellent rates.