Basilar artery occlusion

Lindsberg and Mattle ° recently analyzed published case series reporting on the outcome of basilar artery occlusion (BAO) after lAT or IV thrombolysis. In 420 BAO patients treated with IV thrombolysis (76) and lAT (344), death or dependency was equally common 78% (59 of 76) and 76% (260 of 344). Recanalization was achieved more frequently with lAT (225 of 344 65%) than with IV thrombolysis (40 of 76 53% p = 0.05), but survival rates after IV thrombolysis (38 of 76 50%) and lAT (154 of 344 45%) were equal (p = 0.48). A total of 24% of patients treated with lAT and 22% treated with IV thrombolysis reached good outcomes (p = 0.82). Without recanalization, the likelihood of achieving a good outcome was close to nil (2%). The authors conclude that recanalization occurs in more than half of BAO patients treated with lAT or IV thrombolysis, and 45-55% of survivors regain functional independence. They advised that hospitals not equipped for lAT should consider setting up IV thrombolysis protocols for BAO since the effect of IVT did not appear to be much different from the effect of lAT. 

Yu W, Binder D, Foster-Barber A, Malek R, Smith WS, Higashida RT. Endovascular embolectomy of acute basilar artery occlusion. Neurology 2003 61 1421-1423. 

Lindsberg PJ, Mattie HP. Therapy of basilar artery occlusion a systematic analysis comparing intra-arterial and intravenous thrombolysis. Stroke 2006 37 922-928. 

Eckert B, Koch C, Thomalla G, Roether J, Zeumer H. Acute basilar artery occlusion treated with combined intravenous Abciximab and intra-arterial tissue plasminogen activator report of 3 cases. Stroke 2002 33 1424-1427. 

Bergui M, Stura G, Daniele D, Cerrato P, Berardino M, Bradac GB. Mechanical thrombolysis in ischemic stroke attributable to basilar artery occlusion as first-line treatment. Stroke 2006 37 145-150. 

Unlabeled Uses Acute peripheral occlusive disease, basilar artery occlusion, cerebral infarction, deep vein thrombosis, femoropopliteal artery occlusion, mesenteric or subclavian vein occlusion, pleural effusion (parapneumonic)... 

Biller J, Haberland C, Toffol GJ, O Reilly D, Tentler RL. Basilar artery occlusion in an adolescent girl a risk of oral contraceptives J Child Neurol 1986 l(4) 347-50. 

Ostrem JL, Saver JL, Alger JR, Starkman S, Leary MC, Duck-wiler G, Jahan R, Vespa P, Villablanca JP, Gobin YP, Vin-uela F, Kidwell CS (2004) Acute basilar artery occlusion diffusion-perfusion MRI characterization of tissue salvage... 

Decreased level of consciousness (unless caused by basilar artery occlusion)... 

Clinical and radiological predictors of recanalisation and outcome of 40 patients with acute basilar artery occlusion treated with intra-arterial thrombolysis. Journal of Neurology, Neurosurgery and Psychiatry 75 857-862... 

Lindsberg PJ, Mattie HP (2006). Therapy of basilar artery occlusion a systematic analysis comparing intra-arterial and intravenous thrombolysis. Stroke 37 922-928 Lindsberg PJ, Soinne L, Tatlisumak T et al. (2004). Long-term outcome after intravenous thrombolysis of basilar artery occlusion. Journal of the American Medical Association 292 1862-1866... 

SchonewUle WJ, Wijman CAC, Michel P, Rueckert CM, Weimar C, Mattie HP, Engelter ST, Tanne D, Muir KW, Molina CA, Thijs V, Audebert H, Pfefferkorn T, Szabo K, Lindsberg PJ, de Freitas G, Kappelle LJ, Algra A Treatment and outcomes of acute basilar artery occlusion in the basilar artery international cooperation study (basics) a prospective registry study. Lancet Neurol 2009 8 pp. 724-730. 

Lev MH, Ackerman RH (1999) In re reversible ischemia determined by xenon-enhanced CT after 90 minutes of complete basilar artery occlusion. Am J Neuroradiol 20(10) 2023-2024. 

Carotid Artery Stenosis 131 Basilar Artery Occlusions 132 Intracranial Aneurysms 133 Cerebral Venous Thrombosis 134... 

Although the majority of cerebral infarctions are located in the territories of the internal carotid arteries, 20% of cerebral ischemic infarctions involve tissue supplied by the vertebrobasilar circulation. Basilar artery occlusion is a life-threatening condition whose unfavourable spontaneous prognosis can only be improved by early detection and subsequent aggressive recanafization therapy (Pfefferkorn et al. 2006). 

Pfefferkorn T, Mayer TE, Schulte-Altedorneburg G, Bruck-mann H, Hamann GF, Dichgans M (2006) [Diagnosis and therapy of basilar artery occlusion]. Nervenarzt 77 416-422... 

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