Abstract Details

Title Outcomes of Acute Basilar Occlusion Ischemic Strokes with Advent of Modern Thrombectomy Devices, a New York State Experience

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-030

Objective Basilar artery occlusions (BAO) are among the most devastating subtypes of ischemic stroke that lead to high mortality and poor outcomes. The objective of our study was to evaluate outcomes of patients with ischemic stroke from BAO who received various treatment modalities over time.

Background Recently developed thrombectomy devices, such as aspiration systems (2009) and stent retrievers (2012) have helped in improving the endovascular management of acute ischemic stroke. Contrary to acute ischemic stroke involving the anterior circulation, no randomized trial has yet demonstrated the effectiveness of endovascular management in acute BAO.

Design/Methods

We conducted a retrospective cohort study of patients with ischemic stroke from basilar artery occlusion between 2008 and 2014 using the New York Department of Health Statewide Planning and Research Cooperative System (SPARCS), a comprehensive data reporting system that collects information on hospital admissions and emergency department database. The cohort was divided into two time periods: 2008-2011 and 2012-2014. We compared the outcomes between time periods for each of the treatment modalities, namely, no treatment, intravenous thrombolysis (IV) only, and intra-arterial treatment (IAT) with or without IV.

Results

Similar outcomes were observed in BAO patients who received no treatment (p=0.861) and IV rt-PA (p=0.303). In BAO patients treated with IAT +/- IV, outcomes differed by time period (p=0.002) with in-hospital mortality 29.6% in 2012- 2014 vs. 64.3% in 2008-2011, and discharge home/inpatient rehabilitation 16.7% in 2012-2014 compared to only 4.8% in 2008-2011.

Conclusions Among BAO patients treated with IAT, the proportion who died during hospitalization were lower after 2012. This increased survival was not seen in the IV nor the no treatment group, suggesting that improvements in thrombectomy devices and neuro-interventional techniques may have contributed to the improved outcomes over time, especially after the advent of stent retrievers in 2012.

Authors/Disclosures
Husitha Reddy Vanguru, MBBS PRESENTER	Dr. Vanguru has nothing to disclose.
	No disclosure on file
Carlos Ynigo D. Lopez, MD (The Guthrie Clinic)	Dr. Lopez has nothing to disclose.
Hesham Masoud, MD (Department of Neurology)	Dr. Masoud has nothing to disclose.
Karen C. Albright, DO, DO, PhD, MS, MPH (FDA)	Dr. Albright has nothing to disclose.
Amelia K. Boehme, PhD (Columbia University)	Dr. Boehme has nothing to disclose.

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