Abstract TP40: Outcomes of Thrombectomy in Basilar Artery Occlusions: A Single Center Study

Background: Basilar artery occlusion (BAO) remains a devastating ischemic stroke subtype leading to high mortality rates and poor outcomes. Recently, mechanical retrieval therapy (MER) became a standard of care and a influential predictor of favorable outcomes in anterior circulation stroke patients. However, the use of MER in AIS patients with BAO is not established. Purpose: Our hospital sees over 1600 stroke patients a year with over 18% of stroke patients receiving MER therapy compared to the national average of 4.3%. We sought to evaluate our BAO patients who received MER therapy for efficacy and outcomes. Methods: Patients presenting to our facility between January 1, 2015 and June 30, 2018 were studied in a retrospective chart review. AIS patients who had BAO were evaluated for types of treatment, age, outcomes, recanalization rate TICI score of >2b, and disability or mortality after stroke. Of the 4,212 stroke patients presenting at our facility in the timeframe, 441 underwent MER therapy with 20 patients having a primary occlusion of basilar artery. Data was analyzed and compared to meta-analysis data. Results: Our patients with BAO had a (mRS) modified Rankin Score (0-2) of 81.8% (95% CI 7.8%, 96.8%) compared to the national average of 42.0% (95% CI 36%, 48%). Reperfusion scores (TICI >2b) in our patients was 90.9 % (95% CI 57.1%, 99.5%), while the reperfusion scores (TICI >2b) in the comparison group as 81% (95% CI 73%, 87%). Our sICH rate was 0.0% (95% CI 0.0%, 31.1%) while the comparison group was 4% (95% CI 2.0%, 8.0%). Our overall mortality rate of our BAO patients was 5.1%, with the comparison group’s mortality rate at 30.1%. There was no significance noted in patients’ ages or in the use of thrombolytics between the two groups. Conclusion: Patients presenting with stroke caused by BAO who receive MER at our facility have more favorable outcomes than those in the systematic review. Potential reasons include shorter time to recanalization, improved catheters and technology, experienced staff and strict attention to seamless transitions of care. MER therapy can be a safe treatment modality for patients with BAO. Further clinical trials are needed to show MER efficacy in patients experiencing a BAO.