Clinical outcomes of endovascular therapy in acute basilar artery occlusion with low pc-ASPECTS : Outcomes in ABAO with low pc-ASPECTS.

IF 4.8 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Neurology Pub Date : 2025-05-13 DOI:10.1007/s00415-025-13144-7

Xiaolei Gong, Miao Chai, Xiaolin Tan, Linyu Li, Changwei Guo, Jie Yang, Guojian Liu, Lilan Wang, Xiaolie Shi, Shihai Yang, Jinfu Ma, Xu Xu, Dahong Yang, Wenzhe Sun, Shitao Fan, Jiaxing Song, Wenjie Zi, Zhenchang Zhang

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Abstract

Background: The effectiveness and safety of endovascular therapy (EVT) in patients with Acute Basilar Artery Occlusion (ABAO) with low pc-ASPECTS is unclear.

Objective: To evaluate the effectiveness and safety of EVT in ABAO patients with low pc-ASPECTS.

Methods: We analyzed 199 ABAO patients with pc-ASPECTS ≤ 6 who were prospectively registered in the BASILAR study. The patients were divided into the standard medical treatment group (SMT group) and the endovascular therapy group (EVT group). We compared the differences between the two groups in terms of primary outcomes (mRS scores of 0-3, 0-2 and 0-1 at 1 year), secondary outcomes (mRS scores of 0-3, 0-2 and 0-1 at 90 days), primary safety outcomes (symptomatic intracranial haemorrhage at 48 h, mortality at 90 days).

Results: Among the 199 patients, 134 (67.34%) were in the EVT group. Compared with the SMT group, the EVT group showed a significantly higher likelihood of achieving mRS score of 0-3 [adjusted OR [aOR] 21.17, 95% CI (2.08-215.43), P = 0.010] and mRS score of 0-2 [aOR 16.34, 95% CI (1.64-163.32), P = 0.017] at 1 year. There was no significant difference in safety outcomes at 90 days between the two groups.

Conclusions: EVT improves long-term clinical outcomes in ABAO patients with pc-ASPECTS ≤ 6, patients undergoing EVT demonstrated significantly better functional outcomes at 1 year compared to those receiving SMT, with no significant difference in mortality at 90 days. Overall, ABAO patients treated with EVT achieve both effective and safe outcomes.

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血管内治疗急性基底动脉闭塞低pc-ASPECTS的临床结果：低pc-ASPECTS的ABAO的结果。

背景：血管内治疗（EVT）对低pc-ASPECTS的急性基底动脉闭塞（ABAO）患者的有效性和安全性尚不清楚。目的：评价EVT治疗低pc侧ABAO患者的有效性和安全性。方法：我们分析了199例pc-ASPECTS≤6的ABAO患者，这些患者在BASILAR研究中进行了前瞻性登记。患者分为标准药物治疗组（SMT组）和血管内治疗组（EVT组）。我们比较了两组在主要结局（1年mRS评分0-3、0-2和0-1）、次要结局（90天mRS评分0-3、0-2和0-1）、主要安全结局（48小时症状性颅内出血，90天死亡率）方面的差异。结果199例患者中EVT组134例（67.34%）。与SMT组相比，EVT组1年mRS评分为0-3分[调整OR [aOR] 21.17, 95% CI (2.08-215.43), P = 0.010]和mRS评分为0-2分[aOR 16.34, 95% CI (1.64-163.32), P = 0.017]的可能性显著高于SMT组。两组在90天的安全性结果没有显著差异。结论：EVT改善了pc-ASPECTS≤6的ABAO患者的长期临床结局，与接受SMT的患者相比，接受EVT的患者在1年时表现出明显更好的功能结局，90天死亡率无显著差异。总的来说，接受EVT治疗的ABAO患者获得了有效和安全的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neurology 医学-临床神经学

CiteScore

10.00

自引率

5.00%

发文量

558

审稿时长

1 months

期刊介绍： The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field. In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials. Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.