Objective:

NA

Background:

Basilar Artery Occlusion (BAO) is a deadly condition with mortality rates of 85% to 95% if untreated.  Despite the success of mechanical thrombectomy (MT) in anterior circulation occlusions, its efficacy in BAO has been criticized in the BASICS trial. The goal of our study was to assess functional outcomes at our institution.

Design/Methods:

Hospital records were reviewed for BAO from 2018-2023. Demographics, Modified Rankin Scale (mRS), and mortality of patients undergoing MT vs standard treatment (ST) were compiled. Favorable primary outcome was defined as mRS 0-3. 

Results:

A total of 32 patients (median age of 73), of which males accounted for 65.6% (21/32) were included. There was a statistically significant difference in average age between those who received MT and ST (79 vs. 64 years, p = 0.02). There was no difference in the length of stay between these two groups (19 vs. 13, p = 0.16). Also, 85.7% (6/7) of patients who received MT had a discharge mRS between 4-6, compared to 68% (17/25) of patients who underwent ST.

Conclusions:

The efficacy of MT in BAO is a critical topic. The rarity of BAO makes conducting large, randomized studies challenging. Our study found that BAO patients treated with MT at our institution had improved mRS scores compared to those treated historically.  Some degree of confounding exists, as individuals who underwent MT also required emergent intubation, had bilateral exam findings, and had experienced delayed diagnosis, all of which are factors independently shown to result in poorer outcomes in BAO. Although our findings are encouraging, our limited sample size is an important drawback to acknowledge. This highlights the need to collect further data to optimize BAO outcomes through more extensive studies to determine the effective modality for maximal benefits in patients with devastating BAOs.