Conventional versus advanced imaging selection for endovascular treatment of basilar artery occlusion strokes.
Publication/Presentation Date
8-28-2025
Abstract
INTRODUCTION: Endovascular thrombectomy (EVT) is an effective treatment for basilar artery occlusion (BAO) stroke in select patients. While there is a growing body of literature suggesting that advanced imaging modalities such as computed tomography perfusion (CTP) and magnetic resonance (MR) may not be necessary for selecting anterior circulation large vessel occlusion stroke patients for EVT, whether advanced imaging may be superior to conventional imaging (non-contrast CT and CT angiography) in identifying good treatment candidates among BAO patients is less clear.
PATIENTS AND METHODS: This was a multicenter retrospective cohort study of BAO EVT patients treated from 2013 to 2022 in the Stroke Thrombectomy and Aneurysm Registry. Patients selected for EVT by advanced imaging (CTP or MR) were matched with those selected by conventional imaging using propensity score matching (PSM) accounting for possible confounders. Primary outcome was functional independence at 90 days. Other outcomes include bedridden state or death at 90-days and symptomatic intracranial hemorrhage (sICH).
RESULTS: 268 patients were included. 150 patients were selected for BAO EVT by conventional imaging, 86 by CTP, and 32 by MR. Patients selected by advanced imaging were significantly older than those selected by conventional imaging (median age 71 vs 64 years,
CONCLUSIONS: Selecting patients for basilar EVT using conventional versus advanced imaging did not result in different clinical outcomes, regardless of treatment time windows. Conventional imaging appears sufficient as a first-line tool for selecting basilar EVT patients in routine clinical practice.
First Page
23969873251364973
Last Page
23969873251364973
ISSN
2396-9881
Published In/Presented At
Chen, H., Colasurdo, M., Matsukawa, H., Cunningham, C., Maier, I., Al Kasab, S., Jabbour, P., Kim, J. T., Wolfe, S. Q., Rai, A., Starke, R. M., Psychogios, M. N., Samaniego, E. A., Goyal, N., Yoshimura, S., Cuellar, H., Grossberg, J. A., Alawieh, A., Alaraj, A., Ezzeldin, M., … Kan, P. (2025). Conventional versus advanced imaging selection for endovascular treatment of basilar artery occlusion strokes. European stroke journal, 23969873251364973. Advance online publication. https://doi.org/10.1177/23969873251364973
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
40873294
Department(s)
Administration and Leadership
Document Type
Article