Endovascular Treatment of Acute Basilar Artery Occlusion: Registro Endovascolare Lombardo Occlusione Basilar Artery (RELOBA) Study Group Experience

Andrea Giorgianni, Francesco Biraschi, Mariangela Piano, Dikran Mardighian, Roberto Gasparotti, Michele Frigerio, Guglielmo Pero, Luca Quilici, Mario Crispino, Carlo Pellegrino, Marco Pavia, Roberto Peroni, Marco Longoni, Martino Cellerini, Elvis Lafe, Paolo Remida, Giuseppe Faragò, Paolo Reganati, Sabina Strocchi, Luca Valvassori

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Acute basilar artery occlusion (BAO) is considered among the most severe medical emergencies, with very high morbidity and mortality. The aims of this study are to present 5 years experience of 12 centers in Lombardy region on BAO endovascular treatment and to evaluate prognostic factors that may improve clinical outcomes and recanalization rates.

MATERIALS AND METHODS: Registro Endovascolare Lombardo Occlusione Basilar Artery (RELOBA) registry is a retrospective multicentric collection of patients with acute BAO who underwent endovascular treatment between 2010 and 2015. A total of 102 patients (mean age 65 years) were included. Clinical, procedural, and neuroradiological data were collected. Angiographic results (Treatment in Cerebral Ischemia scale [TICI] score 2b-3) were assessed by each center's interventional neuroradiologist. Good clinical outcome was considered as a modified Rankin Scale score ranging between 0 and 2 in a 3-month follow-up.

RESULTS: Thirty-nine percent of patients showed good clinical outcome at 3 months. Mortality rate was 30%. TICI 2b-3 was achieved in 62% of patients. Univariate analysis showed that age, National Institutes of Health Stroke Scale (NIHSS) at onset, time to recanalization, and TICI score were all statistically significant clinical outcome predictors (P < .05). Multivariate logistic regression showed that time to recanalization, age, and NIHSS at onset were significant independent predictors of good outcome.

CONCLUSIONS: BAO treatment needs more efforts to assure patients better clinical outcomes. Mechanical thrombectomy is feasible and effective in patients with acute BAO. These results must be confirmed by further prospective studies within randomized controlled settings.

Original languageEnglish
Pages (from-to)2367-2374
Number of pages8
JournalJournal of Stroke and Cerebrovascular Diseases
Volume27
Issue number9
DOIs
Publication statusPublished - Sep 2018

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Basilar Artery
Brain Ischemia
National Institutes of Health (U.S.)
Therapeutics
Stroke
Thrombectomy
Mortality
Registries
Emergencies
Logistic Models
Prospective Studies
Morbidity

Keywords

  • Acute Disease
  • Aged
  • Cerebral Angiography
  • Chi-Square Distribution
  • Disability Evaluation
  • Endovascular Procedures/adverse effects
  • Female
  • Humans
  • Italy
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Recovery of Function
  • Registries
  • Retrospective Studies
  • Risk Factors
  • Thrombectomy/adverse effects
  • Time Factors
  • Treatment Outcome
  • Vertebrobasilar Insufficiency/diagnostic imaging

Cite this

Endovascular Treatment of Acute Basilar Artery Occlusion : Registro Endovascolare Lombardo Occlusione Basilar Artery (RELOBA) Study Group Experience. / Giorgianni, Andrea; Biraschi, Francesco; Piano, Mariangela; Mardighian, Dikran; Gasparotti, Roberto; Frigerio, Michele; Pero, Guglielmo; Quilici, Luca; Crispino, Mario; Pellegrino, Carlo; Pavia, Marco; Peroni, Roberto; Longoni, Marco; Cellerini, Martino; Lafe, Elvis; Remida, Paolo; Faragò, Giuseppe; Reganati, Paolo; Strocchi, Sabina; Valvassori, Luca.

In: Journal of Stroke and Cerebrovascular Diseases, Vol. 27, No. 9, 09.2018, p. 2367-2374.

Research output: Contribution to journalArticle

Giorgianni, A, Biraschi, F, Piano, M, Mardighian, D, Gasparotti, R, Frigerio, M, Pero, G, Quilici, L, Crispino, M, Pellegrino, C, Pavia, M, Peroni, R, Longoni, M, Cellerini, M, Lafe, E, Remida, P, Faragò, G, Reganati, P, Strocchi, S & Valvassori, L 2018, 'Endovascular Treatment of Acute Basilar Artery Occlusion: Registro Endovascolare Lombardo Occlusione Basilar Artery (RELOBA) Study Group Experience', Journal of Stroke and Cerebrovascular Diseases, vol. 27, no. 9, pp. 2367-2374. https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.04.022
Giorgianni, Andrea ; Biraschi, Francesco ; Piano, Mariangela ; Mardighian, Dikran ; Gasparotti, Roberto ; Frigerio, Michele ; Pero, Guglielmo ; Quilici, Luca ; Crispino, Mario ; Pellegrino, Carlo ; Pavia, Marco ; Peroni, Roberto ; Longoni, Marco ; Cellerini, Martino ; Lafe, Elvis ; Remida, Paolo ; Faragò, Giuseppe ; Reganati, Paolo ; Strocchi, Sabina ; Valvassori, Luca. / Endovascular Treatment of Acute Basilar Artery Occlusion : Registro Endovascolare Lombardo Occlusione Basilar Artery (RELOBA) Study Group Experience. In: Journal of Stroke and Cerebrovascular Diseases. 2018 ; Vol. 27, No. 9. pp. 2367-2374.
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TY - JOUR

T1 - Endovascular Treatment of Acute Basilar Artery Occlusion

T2 - Registro Endovascolare Lombardo Occlusione Basilar Artery (RELOBA) Study Group Experience

AU - Giorgianni, Andrea

AU - Biraschi, Francesco

AU - Piano, Mariangela

AU - Mardighian, Dikran

AU - Gasparotti, Roberto

AU - Frigerio, Michele

AU - Pero, Guglielmo

AU - Quilici, Luca

AU - Crispino, Mario

AU - Pellegrino, Carlo

AU - Pavia, Marco

AU - Peroni, Roberto

AU - Longoni, Marco

AU - Cellerini, Martino

AU - Lafe, Elvis

AU - Remida, Paolo

AU - Faragò, Giuseppe

AU - Reganati, Paolo

AU - Strocchi, Sabina

AU - Valvassori, Luca

N1 - Copyright © 2018. Published by Elsevier Inc.

PY - 2018/9

Y1 - 2018/9

N2 - BACKGROUND: Acute basilar artery occlusion (BAO) is considered among the most severe medical emergencies, with very high morbidity and mortality. The aims of this study are to present 5 years experience of 12 centers in Lombardy region on BAO endovascular treatment and to evaluate prognostic factors that may improve clinical outcomes and recanalization rates.MATERIALS AND METHODS: Registro Endovascolare Lombardo Occlusione Basilar Artery (RELOBA) registry is a retrospective multicentric collection of patients with acute BAO who underwent endovascular treatment between 2010 and 2015. A total of 102 patients (mean age 65 years) were included. Clinical, procedural, and neuroradiological data were collected. Angiographic results (Treatment in Cerebral Ischemia scale [TICI] score 2b-3) were assessed by each center's interventional neuroradiologist. Good clinical outcome was considered as a modified Rankin Scale score ranging between 0 and 2 in a 3-month follow-up.RESULTS: Thirty-nine percent of patients showed good clinical outcome at 3 months. Mortality rate was 30%. TICI 2b-3 was achieved in 62% of patients. Univariate analysis showed that age, National Institutes of Health Stroke Scale (NIHSS) at onset, time to recanalization, and TICI score were all statistically significant clinical outcome predictors (P < .05). Multivariate logistic regression showed that time to recanalization, age, and NIHSS at onset were significant independent predictors of good outcome.CONCLUSIONS: BAO treatment needs more efforts to assure patients better clinical outcomes. Mechanical thrombectomy is feasible and effective in patients with acute BAO. These results must be confirmed by further prospective studies within randomized controlled settings.

AB - BACKGROUND: Acute basilar artery occlusion (BAO) is considered among the most severe medical emergencies, with very high morbidity and mortality. The aims of this study are to present 5 years experience of 12 centers in Lombardy region on BAO endovascular treatment and to evaluate prognostic factors that may improve clinical outcomes and recanalization rates.MATERIALS AND METHODS: Registro Endovascolare Lombardo Occlusione Basilar Artery (RELOBA) registry is a retrospective multicentric collection of patients with acute BAO who underwent endovascular treatment between 2010 and 2015. A total of 102 patients (mean age 65 years) were included. Clinical, procedural, and neuroradiological data were collected. Angiographic results (Treatment in Cerebral Ischemia scale [TICI] score 2b-3) were assessed by each center's interventional neuroradiologist. Good clinical outcome was considered as a modified Rankin Scale score ranging between 0 and 2 in a 3-month follow-up.RESULTS: Thirty-nine percent of patients showed good clinical outcome at 3 months. Mortality rate was 30%. TICI 2b-3 was achieved in 62% of patients. Univariate analysis showed that age, National Institutes of Health Stroke Scale (NIHSS) at onset, time to recanalization, and TICI score were all statistically significant clinical outcome predictors (P < .05). Multivariate logistic regression showed that time to recanalization, age, and NIHSS at onset were significant independent predictors of good outcome.CONCLUSIONS: BAO treatment needs more efforts to assure patients better clinical outcomes. Mechanical thrombectomy is feasible and effective in patients with acute BAO. These results must be confirmed by further prospective studies within randomized controlled settings.

KW - Acute Disease

KW - Aged

KW - Cerebral Angiography

KW - Chi-Square Distribution

KW - Disability Evaluation

KW - Endovascular Procedures/adverse effects

KW - Female

KW - Humans

KW - Italy

KW - Logistic Models

KW - Male

KW - Middle Aged

KW - Multivariate Analysis

KW - Recovery of Function

KW - Registries

KW - Retrospective Studies

KW - Risk Factors

KW - Thrombectomy/adverse effects

KW - Time Factors

KW - Treatment Outcome

KW - Vertebrobasilar Insufficiency/diagnostic imaging

U2 - 10.1016/j.jstrokecerebrovasdis.2018.04.022

DO - 10.1016/j.jstrokecerebrovasdis.2018.04.022

M3 - Article

C2 - 29958848

VL - 27

SP - 2367

EP - 2374

JO - Journal of Stroke and Cerebrovascular Diseases

JF - Journal of Stroke and Cerebrovascular Diseases

SN - 1052-3057

IS - 9

ER -