title: Combined treatment with intravenous abciximab and intraarterial tPA yields high recanalization rate in patients with acute basilar artery occlusion.
abstract: BACKGROUND
  The best therapeutic approach in patients with acute basilar artery occlusion (BAO) remains unclear. We report the results of a combined treatment approach with intravenous (IV) abciximab and intraarterial (IA) tissue plasminogen activator (tPA) in these patients.
  
  
  METHODS
  We prospectively studied patients with acute BAO on CT-angiography or MR-angiography. We treated patients with IV abciximab followed by IA thrombolysis with tPA. Primary outcome was partial or complete recanalization according to thrombolysis in myocardial infarction 2 to 3 flow grades on catheter angiography. Secondary outcomes were favorable functional outcome (mRS score ≤3) and mortality at 90 days.
  
  
  RESULTS
  Of 20 patients, mean age was 62 ± 13 years, median baseline National Institutes of Health Stroke Scale (NIHSS) score 25.5 (IQR 12-28), and median Glasgow Coma Scale score 7 (IQR 6-11). Mean time to IA treatment was 7 ± 2.8 hours. We achieved partial or complete recanalization in 17/20 patients (85%). At 3 months, 3/20 patients (15%) had a favorable functional outcome and 9/20 patients (45%) were deceased.
  
  
  CONCLUSIONS
  Combined treatment with IV abciximab and IA tPA yielded a high recanalization rate in patients with BAO. However, functional outcomes were poor, potentially due to late initiation of treatment. Early treatment might improve functional outcome.
authors.affiliation: Department of Neurology, Dresden University Stroke Center, University of Technology Dresden, Dresden, Germany. Barlinn@uniklinikum-dresden.de
authors.forename: Kristian
authors.initials: K
authors.lastname: Barlinn
authors.forename: Ulf
authors.initials: U
authors.lastname: Becker
authors.forename: Volker
authors.initials: V
authors.lastname: Puetz
authors.forename: Imanuel
authors.initials: I
authors.lastname: Dzialowski
authors.forename: Alexander
authors.initials: A
authors.lastname: Kunz
authors.forename: Jessica
authors.initials: J
authors.lastname: Kepplinger
authors.forename: Rüdiger
authors.initials: R
authors.lastname: von Kummer
authors.forename: Georg
authors.initials: G
authors.lastname: Gahn
mesh_terms: D000077284:Abciximab; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000188:drug therapy*
chemical_list: D000911:Antibodies, Monoclonal; D005343:Fibrinolytic Agents; D007140:Immunoglobulin Fab Fragments; D010959:Tissue Plasminogen Activator; D000077284:Abciximab