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Outcome in patients with basilar artery occlusion treated conventionally

¹ Department of Neurology, Rudolph Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, Netherlands
² Department of Neurology, Hospital Universitari Doctor Josep Trueta, Girona, Spain
³ Cerebrovascular Unit, Department of Neurology, Hospital Vall d’Hebron, Barcelona, Spain

Correspondence to:
Correspondence to:
Dr Wouter J Schonewille
University Medical Centre Utrecht, Department of Neurology, HP G 03.228, PO box 85500, 3508 GA Utrecht, Netherlands; w.j.schonewille{at}neuro.azu.nl

Background: Most data on the outcome of basilar artery occlusion are from recent case series of patients treated with intra-arterial thrombolysis. The limited knowledge on the outcome after a conventional treatment approach comes from a few small case series of highly selected patients.

Objective: To provide more data on the outcome of conventional treatment.

Methods: Data were analysed on patients from three centres with symptomatic basilar artery occlusion treated conventionally. Conventional therapy was defined as treatment with antiplatelets, anticoagulation, or both.

Results: Data were available on 82 patients. The case fatality was 40%. Among survivors, 65% remained dependent (Rankin score 4–5). Patients younger than 60 years (odds ratio = 3.1 (95% confidence interval, 1.0 to 9.5)) and those with a minor stroke (OR = 3.1 (1.0 to 9.6)) were more likely to have a good outcome (Rankin score 0–3). Patients with a progressive stroke were less likely to have a good outcome (OR = 0.3 (0.08 to 1.2)) than patients with a maximum deficit at onset or fluctuating symptoms at presentation.

Conclusions: Conventional treatment of symptomatic basilar artery occlusion is associated with a poor outcome in almost 80% of patients, which emphasises the importance of the search for a more effective treatment approach.

Keywords: basilar artery; treatment; outcome

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