Basilar artery occlusion (BAO) remains a devastating ischemic stroke subtype associated with high mortality rates and poor outcomes. Recently, mechanical retrieval therapy (MER) became a standard of care and a influential predictor of favorable outcomes in anterior circulation stroke patients. However, the use of MER in acute ischemic stroke (AIS) patients with BAO is not established.

Patients admitted between January 1, 2015 and June 30, 2018 were studied in a retrospective chart review.  AIS patients with BAO were evaluated for types of treatment, age, outcomes, recanalization rate TICI score of >2b, and disability or mortality after stroke. Of the 4,212 stroke patients presenting at our facility, 441 underwent MER therapy with 20 patients having a primary occlusion of the basilar artery. Data was analyzed and then compared to meta-analysis data.

Our patients with BAO had a (mRS) modified Rankin Score (0-2) of 81.8% (95% CI 7.8%, 96.8%) compared to the comparison group¹ of 42.0% (95% CI 36%, 48%). The sICH rate was 0.0% (95% CI 0.0%, 31.1%) while the comparison group¹ was 4% (95% CI 2.0%, 8.0%). Our overall mortality rate of our BAO patients was 5.1%, with the comparison group’s¹ mortality rate at 30.1%. There was no significant difference noted in patients’ ages or in the use of thrombolytics between the two groups.

Patients presenting with stroke caused by BAO strokes who receive MER at our facility have better outcomes than those in the systematic review. Potential reasons include time to recanalization, improved catheters and technology, experienced staff and attention to transitions of care. MER therapy is a safe treatment modality for patients with BAO.