Real-world effectiveness of thrombectomy for basilar artery occlusion: lessons beyond the ATTENTION and BAOCHE trials
Rattachement africain : kr, Éthiopie, Nigéria, us. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: The ATTENTION (0-12 hours) and BAOCHE (6-24 hours) trials demonstrated the efficacy of endovascular treatment (EVT) for basilar artery occlusion (BAO) in highly selected populations, but real-world generalizability remains uncertain. PATIENTS AND METHODS: We analyzed patients with acute BAO presenting within 24 hours of last known well from a nationwide, multicenter, prospective stroke registry. Patients were categorised as ATTENTION-eligible, BAOCHE-eligible, and ineligible based on clinical and neuroimaging criteria from both trials. The primary outcome was the distribution of 3-month modified Rankin Scale (mRS). Secondary outcomes included 3-month mRS of 0-3 and 0-2, 90-day mortality, and symptomatic hemorrhagic transformation. Inverse probability of treatment weighting was applied to adjust for baseline differences. RESULTS: Among 49,471 patients with acute ischemic stroke, 2.0% (n = 1012) had BAO. Of these, 24% met ATTENTION-criteria, 6% met BAOCHE-criteria, and 72% were ineligible for both. Endovascular treatment was performed in 75%, 59%, and 43% of these groups, respectively. In ATTENTION-eligible patients, EVT was associated with more favourable mRS distribution (cOR, 1.73; 95% CI, 1.03-2.93) and lower 3-month mortality (RR, 0.52; 95% CI, 0.33-0.80). In BAOCHE-eligible patients, adjusted models did not reach statistical significance due to limited sample size. Among ineligible patients, EVT was associated with lower mortality (RR, 0.77; 95% CI, 0.60-0.99). Symptomatic haemorrhage rates did not differ across groups. CONCLUSION: Most BAO patients were ineligible for pivotal EVT trials, and eligibility for the more stringent BAOCHE criteria was particularly rare in real-world practice. Endovascular treatment was associated with reduced mortality even in ineligible patients. These findings highlight the practical limitations of current trial-based selection criteria and support broader application of EVT for BAO.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Real-world effectiveness of thrombectomy for basilar artery occlusion: lessons beyond the ATTENTION and BAOCHE trials
- Date Crossref
- 01/05/2026
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Korea University Department of Neurology pays non établi dans la noticeUniversité ou école supérieure
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Soonchunhyang University Hospital Seoul Department of Neurology pays non établi dans la noticeÉtablissement de santé
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Asan Medical Center pays non établi dans la noticeÉtablissement de santé
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New Generation University College Éthiopie (code pays fourni par la source)Université ou école supérieure
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Yeungnam University Medical Center Department of Neurology pays non établi dans la noticeÉtablissement de santé
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Korea University Medical Center pays non établi dans la noticeÉtablissement de santé
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Korea University Guro Hospital pays non établi dans la noticeÉtablissement de santé
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Eulji University Department of Neurology pays non établi dans la noticeUniversité ou école supérieure
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Sacred Heart Hospital Department of Neurology Nigéria (code pays fourni par la source)Établissement de santé
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Hallym University Chuncheon Sacred Heart Hospital pays non établi dans la noticeÉtablissement de santé
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Eulji University Nowon Eulji Medical Center pays non établi dans la noticeÉtablissement de santé
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Dong-A University Hospital Department of Neurology pays non établi dans la noticeÉtablissement de santé
Department of Neurology — Korea University, Department of Neurology — Soonchunhyang University Hospital Seoul et Asan Medical Center, avec 9 autres affiliations. Pays d’affiliation : Éthiopie, Nigéria.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.