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Basilar artery occlusion management: An international survey of middle versus high-income countries

Basilar artery occlusion management: An international survey of middle versus high-income countries

Authors :
Drumm, Brian
Herning, Ana
Klein, Piers
Raymond, Jean
Abdalkader, Mohamad
Huo, Xiaochuan
Chen, Yimin
Siegler, James E.
Peacock, Meabh
Schonewille, Wouter J.
Liu, Xinfeng
Hu, Wei
Ji, Xunming
Li, Chuanhui
Alemseged, Fana
Liu, Liping
Nagel, Simon
Strbian, Daniel
Rebello, Leticia C.
Yaghi, Shadi
Qureshi, Muhammad M.
Fischer, Urs
Tsivgoulis, Georgios
Kaesmacher, Johannes
Yamagami, Hiroshi
Puetz, Volker
Sylaja, PN
Marto, João Pedro
Sacco, Simona
Kristoffersen, Espen Saxhaug
Demeestere, Jelle
Conforto, Adriana B.
Meyer, Lukas
Kaiser, Daniel P.O.
Reiff, Tilman
Aydin, Kubilay
Romoli, Michele
Diana, Francesco
Lobotesis, Kyriakos
Roi, Dylan
Masoud, Hesham E.
Ma, Alice
Mohammaden, Mahmoud H.
Doheim, Mohamed F.
Zhu, Yuyou
Sang, Hongfei
Sun, Dapeng
Ton, Mai Duy
Raynald
Li, Fengli
Lapergue, Bertrand
Hanning, Uta
Yang, Qingwu
Lee, Jin Soo
Thomalla, Götz
Yang, Pengfei
Liu, Jianmin
Campbell, Bruce C.V.
Chen, Hui-Sheng
Zaidat, Osama O.
Qiu, Zhongming
Nogueira, Raul G.
Miao, Zhongrong
Nguyen, Thanh N.
Banerjee, Soma
Source :
Interventional Neuroradiology; 20240101, Issue: Preprints
Publication Year :
2024

Abstract

Background and Purpose Two early basilar artery occlusion (BAO) randomized controlled trials (RCTs) did not establish the superiority of endovascular thrombectomy (EVT) over medical management. Yet many providers continued to recommend EVT. The goal of the present article is to compare physicians’ diagnostic and management strategies of BAO among middle-income and high-income countries (MICs and HICs, respectively).Methods We conducted an international survey from January to March 2022 regarding management strategies in acute BAO, to examine clinical and imaging parameters influencing clinician management of patients with BAO. We compared responses between physicians from HIC and MIC.Results Among the 1245 respondents from 73 countries, 799 (64.2%) were from HIC, with the remaining 393 (31.6%) from MIC. Most respondents perceived that EVT was superior to medical management for acute BAO, but more so in respondents from HIC (98.0% vs. 94.2%, p < 0.01). MIC respondents were more likely to believe further RCTs were warranted (91.6% vs. 74.0%, p < 0.01) and were more likely to find it acceptable to enroll any patient who met a trial’s criteria in the standard medical treatment arm (58.8% vs. 38.5%, p < 0.01).Conclusions In an area where clinical equipoise was called into question despite the lack of RCT evidence, we found that respondents from MIC were more likely to express willingness to enroll patients with BAO in an RCT than their HIC counterparts.

Details

Language :
English
ISSN :
15910199 and 23852011
Issue :
Preprints
Database :
Supplemental Index
Journal :
Interventional Neuroradiology
Publication Type :
Periodical
Accession number :
ejs65990791
Full Text :
https://doi.org/10.1177/15910199221143190