2023 Annual Meeting | C193 - Basilar Artery Occlusion: What Is New Is Old Again

Date Thursday 04/27/23

Time 08:00 AM - 09:00 AM EST Add To Calendar

Session Format This program will be presented both in-person and online

On Demand This program will be available in the meeting's On Demand product.

Event Type Seminar

Director(s) Fawaz Al-Mufti, MD

Topic(s) Cerebrovascular Disease and Interventional Neurology

Learning Objectives Acute ischemic stroke is a leading cause of death and severe long-term disability. Basilar artery occlusions (BAO), which account for approximately 10% of large vessel strokes, confer especially poor outcomes, as severe deficits persist in 80% or more of patients following treatment and nearly 40% experience mortality. Although a preponderance of evidence had previously demonstrated equipoise between endovascular thrombectomy (EVT) and medical therapy alone for the treatment of acute BAO, recent randomized clinical trial data have, for the first time, demonstrated a clinical benefit to EVT in the posterior circulation. Past clinical trials evaluating endovascular therapy in BAO patients (BASICS and BEST) failed to demonstrate a clinical benefit to EVT, however these findings were met with methodological criticism due to patient crossover, poor recruitment rates, and potential dilution of treatment effect by inclusion of BAO of mild severity (which has not been established as a treatment indication for EVT in the anterior circulation). Data from the BAOCHE trial presented at the May 2022 European Stroke Organization Conference (ESOC) was the first evidence of a clinical benefit to EVT in BAO, demonstrating an improvement in mRS score of 0-3 at 90 days as well as a trend towards lower mortality rates in comparison with medical management alone. These results were followed shortly after by those of the ATTENTION trial, also presented at ESOC, which revealed a similar benefit of EVT to those of the BAOCHE trial in terms of functional status at 90 days and decreased mortality. These trials provided novel evidence for the efficacy of EVT in ischemic stroke of the posterior circulation.

CME Available 1.00 CME credit

Core Competencies Patient Care & Procedural Skills, Medical Knowledge, Practice-based Learning and Improvement, Systems-based Practice, Quality Improvement

Program Level Advanced

Recommended Audience Fellow, Resident, General Neurologist, Specialist Neurologist, Non-neurologist, Advanced Practice Provider, Neurohospitalist, Medical Student

Teaching Styles Didactic, Audience Participation

Event Timeline
08:00 AM - 08:01 AM EST	Introduction	Welcome and Introduction to the Basilar Artery Occlusion: What is New is Old Again Fawaz Al-Mufti, MD, Gabor Toth, MD
08:01 AM - 08:10 AM EST	Speaker	Trials and Tribulations of Basilar Artery Occlusion Strokes Fawaz Al-Mufti, MD
08:10 AM - 08:25 AM EST	Speaker	Endovascular Thrombectomy for Basilar Artery Occlusion — The BAOCHE Trial Tudor G. Jovin, MD
08:25 AM - 08:40 AM EST	Speaker	The ATTENTION Trial: Endovascular Treatment for Acute Basilar Artery Occlusion Raul G. Nogueira, MD
08:40 AM - 08:45 AM EST	Speaker	Real-world Outcomes of Endovascular Thrombectomy for Treatment of Acute Basilar Artery Occlusion: The BARONIS Study Fawaz Al-Mufti, MD
08:45 AM - 09:00 AM EST	Speaker	Rescue Endovascular Stenting of Recalcitrant Basilar Artery Occlusion Gabor Toth, MD
09:00 AM - 09:00 AM EST	Closing Remarks	Closing Remarks Fawaz Al-Mufti, MD, Gabor Toth, MD

Faculty Disclosures
Fawaz Al-Mufti, MD	Dr. Al-Mufti has received personal compensation in the range of $0-$499 for serving as a Consultant for Stryker. Dr. Al-Mufti has received personal compensation in the range of $0-$499 for serving as a Consultant for Cerenovus. Dr. Al-Mufti has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Revalesio .
Gabor Toth, MD	Dr. Toth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Dynamed. Dr. Toth has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. Dr. Toth has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kaneka. Dr. Toth has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Penumbra.
Tudor G. Jovin, MD	Dr. Jovin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerenovus. Dr. Jovin has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Contego Medical. Dr. Jovin has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Several law firms. Dr. Jovin has stock in Corindus. Dr. Jovin has stock in Methinks. Dr. Jovin has stock in Viz.ai. Dr. Jovin has stock in Route92. Dr. Jovin has stock in FreeOx Biotech. Dr. Jovin has stock in Galaxy. Dr. Jovin has stock in Kandu. The institution of Dr. Jovin has received research support from Stryker. The institution of Dr. Jovin has received research support from Medtronic.
Raul G. Nogueira, MD	Dr. Nogueira has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for for advisory roles with Anaconda, Biogen, Cerenovus, Genentech, Hybernia, Imperative Care, Medtronic, Phenox, Philips, Prolong Pharmaceuticals, Stryker Neurovascular, Shanghai Wallaby, and Synchron (consulting fees) as well as for advisory roles with Astrocyte, Brainomix, Cerebrotech, Ceretrieve, Corindus Vascular Robotics, Vesalio, Viz-AI, RapidPulse and Perfuze ( stock options). Dr. Nogueira has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Law Firms. Dr. Nogueira has received stock or an ownership interest from Viz-AI, Perfuze, Cerebrotech, Reist/Q'Apel Medical, Truvic, and Viseon. The institution of Dr. Nogueira has received research support from Cerenovus.

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