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

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.