[Acute basilar artery thrombosis].
Acute basilar artery thrombosis (ABT) has been largely considered a neurological catastrophe. With conventional treatment, only around 20% of patients achieve functional independence. An early presumptive diagnosis is essential to avoid treatment delay. Either multiparametric magnetic resonance imaging or computed tomography angiography source images may represent valid non-invasive tools to confirm ABT and evaluate ischemic tissue viability. The main determinant of ABT outcome is early recanalization but the most effective therapeutic option remains to be clarified. The BASICS prospective registry showed no superiority of intra-arterial over intravenous thrombolysis. Therefore, in the absence of contraindications, intravenous thrombolysis should be started as soon as possible and can be used as the main therapy when interventional procedures are not available. However, recent case series have reported high rates of functional independence (50%) after staged escalation therapy (ultra-early intravenous thrombolysis followed by on-demand endovascular mechanical thrombectomy). These results represent a hope for patients and neurologists and reinforce the need for innovation and research in this field.
Unidad de Ictus, Servicio de Neurología, Hospital Clínico Universitario, Valladolid, España. juanfarenillas@gmail.com
J F
JF
Arenillas Lara
D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D001488:Basilar Artery / Q000473:pathology*; D000075202:Contraindications; D006801:Humans; D020767:Intracranial Thrombosis / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D008279:Magnetic Resonance Imaging / Q000379:methods; D011379:Prognosis; D015912:Thrombolytic Therapy / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods