title: Endovascular treatment of acute basilar artery occlusion: time to treatment is crucial.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of multimodal endovascular treatment (EVT) of acute basilar artery occlusion (BAO), including bridging therapy [intravenous thrombolysis (IVT) with subsequent EVT], to compare particular EVT techniques and identify predictors of clinical outcome.
  
  
  METHODS
  This retrospective, multi-centre study comprised 72 acute ischaemic stroke patients (51 males; mean age 59.1 ± 13.3 years) with radiologically confirmed BAO. The following data were collected: baseline characteristics, risk factors, pre-event antithrombotic treatment, neurological deficit at time of treatment, localization of occlusion, time to therapy, recanalization rate, post-treatment imaging findings. Thirty- and 90-day outcomes were evaluated using the modified Rankin scale with a good clinical outcome defined as 0-3 points.
  
  
  RESULTS
  Successful recanalization was achieved in 94.4% patients. Stepwise binary logistic regression analysis identified the presence of arterial hypertension (OR = 0.073 and OR = 0.067, respectively), National Institutes of Health Stroke Scale (NIHSS) at the time of treatment (OR = 0,829 and OR = 0.864, respectively), and time to treatment (OR = 0.556 and OR = 0.502, respectively) as significant independent predictors of 30- and 90-day clinical outcomes.
  
  
  CONCLUSIONS
  Data from this multicentre study showed that multimodal EVT was an effective recanalization method in acute BAO. Bridging therapy shortens the time to treatment, which was identified as the only modifiable outcome predictor.
authors.affiliation: Department of Neurology, Palacký University, Olomouc, Czech Republic; Comprehensive Stroke Center, Department of Neurology, University Hospital Olomouc, Czech Republic.
authors.forename: T
authors.initials: T
authors.lastname: Dorňák
authors.affiliation: Department of Neurology, Palacký University, Olomouc, Czech Republic; Comprehensive Stroke Center, Department of Neurosurgery, Military University Hospital Prague, Czech Republic. Electronic address: herzig.roman@seznam.cz.
authors.forename: R
authors.initials: R
authors.lastname: Herzig
authors.affiliation: Comprehensive Stroke Center, Department of Neurology, Ostrava University and University Hospital Ostrava, Czech Republic.
authors.forename: M
authors.initials: M
authors.lastname: Kuliha
authors.affiliation: Comprehensive Stroke Center, Department of Neurology, Military University Hospital Prague, Czech Republic.
authors.forename: R
authors.initials: R
authors.lastname: Havlíček
authors.affiliation: Department of Neurology, Palacký University, Olomouc, Czech Republic.
authors.forename: D
authors.initials: D
authors.lastname: Školoudík
authors.affiliation: Comprehensive Stroke Center, Department of Neurology, University Hospital Olomouc, Czech Republic.
authors.forename: D
authors.initials: D
authors.lastname: Šaňák
authors.affiliation: Comprehensive Stroke Center, Department of Radiology, Palacký University and University Hospital Olomouc, Czech Republic.
authors.forename: M
authors.initials: M
authors.lastname: Köcher
authors.affiliation: Comprehensive Stroke Center, Department of Radiology, Ostrava University and University Hospital Ostrava, Czech Republic.
authors.forename: V
authors.initials: V
authors.lastname: Procházka
authors.affiliation: Comprehensive Stroke Center, Department of Radiology, Military University Hospital Prague, Czech Republic.
authors.forename: J
authors.initials: J
authors.lastname: Lacman
authors.affiliation: Comprehensive Stroke Center, Department of Radiology, Military University Hospital Prague, Czech Republic.
authors.forename: F
authors.initials: F
authors.lastname: Charvát
authors.affiliation: Comprehensive Stroke Center, Department of Radiology, Charles University and University Hospital Hradec Králové, Czech Republic.
authors.forename: A
authors.initials: A
authors.lastname: Krajina
authors.affiliation: Comprehensive Stroke Center, Department of Neurology, Charles University and University Hospital Hradec Králové, Czech Republic.
authors.forename: D
authors.initials: D
authors.lastname: Krajíčková
authors.affiliation: Department of Neurology, Palacký University, Olomouc, Czech Republic; Comprehensive Stroke Center, Department of Neurology, University Hospital Olomouc, Czech Republic.
authors.forename: M
authors.initials: M
authors.lastname: Král
authors.affiliation: Department of Neurology, Palacký University, Olomouc, Czech Republic; Comprehensive Stroke Center, Department of Neurology, University Hospital Olomouc, Czech Republic.
authors.forename: T
authors.initials: T
authors.lastname: Veverka
authors.affiliation: Comprehensive Stroke Center, Department of Neurology, Ostrava University and University Hospital Ostrava, Czech Republic.
authors.forename: M
authors.initials: M
authors.lastname: Roubec
authors.affiliation: Comprehensive Stroke Center, Department of Neurology, Military University Hospital Prague, Czech Republic.
authors.forename: L
authors.initials: L
authors.lastname: Hajduková
authors.affiliation: Department of Medical Biophysics, Palacký University Olomouc, Czech Republic.
authors.forename: J
authors.initials: J
authors.lastname: Zapletalová
mesh_terms: D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000628:therapy*; D001488:Basilar Artery; D003131:Combined Modality Therapy; D003952:Diagnostic Imaging; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome