title: Three-month and long-term outcomes and their predictors in acute basilar artery occlusion treated with intra-arterial thrombolysis.
abstract: OBJECTIVE
  Intra-arterial thrombolysis can be used for treatment of basilar artery occlusion. Predictors of outcome before initiation of treatment are of special interest.
  
  
  METHODS
  From 1992 to 2010, we treated 106 consecutive patients with basilar artery occlusion with intra-arterial thrombolysis. Baseline characteristics, treatment, clinical course, and 3-month and long-term outcomes (≥12 months) were assessed. Outcome parameters were vessel recanalization after treatment, complications, modified Rankin scale (mRS) score, and mortality after 3 months and in the long-term.
  
  
  RESULTS
  At 3 months, clinical outcome was good (mRS score, 0-2) in 33.0% of the patients and moderate (mRS score, 3) in 11.3%. Mortality was 40.6%. Partial or complete recanalization was achieved in 69.8% of the patients, and symptomatic intracranial hemorrhage occurred in 1 patient (0.9%). Between 3-month and long-term follow-up, 22 survivors (40.8%) showed clinical improvement of at least 1 point on the mRS score, 29 (53.7%) were functionally unchanged, and 3 (5.7%) showed functional worsening (P<0.0001). Multivariate analysis identified diabetes as a predictor of poor vessel recanalization (P=0.028). Low baseline National Institutes of Health Stroke Scale score was identified as a predictor of good or moderate clinical outcome (P<0.0001) and survival (P=0.001) at 3 months, and younger age was identified as an additional predictor of survival (P=0.012). For prediction of long-term clinical outcome, age was also an independent predictor (P=0.018).
  
  
  CONCLUSIONS
  In our series, intra-arterial thrombolysis as treatment of basilar artery occlusion was safe. National Institutes of Health Stroke Scale score at admission and age were identified as predictors of outcome, and these predictors should be considered for treatment allocation in future randomized trials.
authors.affiliation: Department of Neuroradiology, University of Bern, Inselspital, Freiburgstrasse 10, 3010 Bern, Switzerland.
authors.forename: Simon
authors.initials: S
authors.lastname: Jung
authors.forename: Marie-Luise
authors.initials: ML
authors.lastname: Mono
authors.forename: Urs
authors.initials: U
authors.lastname: Fischer
authors.forename: Aekaterini
authors.initials: A
authors.lastname: Galimanis
authors.forename: Oliver
authors.initials: O
authors.lastname: Findling
authors.forename: Gian Marco
authors.initials: GM
authors.lastname: De Marchis
authors.forename: Anja
authors.initials: A
authors.lastname: Weck
authors.forename: Krassen
authors.initials: K
authors.lastname: Nedeltchev
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Colucci
authors.forename: Pasquale
authors.initials: P
authors.lastname: Mordasini
authors.forename: Caspar
authors.initials: C
authors.lastname: Brekenfeld
authors.forename: Marwan
authors.initials: M
authors.lastname: El-Koussy
authors.forename: Jan
authors.initials: J
authors.lastname: Gralla
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schroth
authors.forename: Heinrich P
authors.initials: HP
authors.lastname: Mattle
authors.forename: Marcel
authors.initials: M
authors.lastname: Arnold
mesh_terms: D000367:Age Factors; D000368:Aged; D001488:Basilar Artery / Q000473:pathology*; D005260:Female; D006801:Humans; D007269:Injections, Intra-Arterial / Q000379:methods; D020300:Intracranial Hemorrhages / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D020521:Stroke / Q000473:pathology* / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000473:pathology