Real-World Outcomes of Endovascular Thrombectomy for Basilar Artery Occlusion: Results of the BArONIS Study

Authors

Alis J. Dicpinigaitis
Rosalind Dick-Godfrey
Olivia Gellerson
Steven D. Shapiro
Haris Kamal
Sherief Ghozy
Gurmeen Kaur
Shashvat M. Desai
Santiago Ortega-Gutierrez
Ameer E. Hassan, The University of Texas Rio Grande Valley

Document Type

Article

Publication Date

3-10-2023

Abstract

Objective

To evaluate clinical outcomes of endovascular thrombectomy (EVT) for acute basilar artery occlusion (BAO) using population-level data from the United States.

Methods

Weighted discharge data from the National Inpatient Sample were queried to identify adult patients with acute BAO during the period of 2015 to 2019 treated with EVT or medical management only. Complex samples statistical methods and propensity-score adjustment using inverse probability of treatment weighting (IPTW) were performed to assess clinical endpoints.

Results

Among 3,950 BAO patients identified, 1,425 (36.1%) were treated with EVT [mean age 66.7 years, median National Institute of Health Stroke Scale (NIHSS) score 22]. On unadjusted analysis, 155 (10.9%) EVT patients achieved favorable functional outcomes (discharge disposition to home without services), while 515 (36.1%) experienced in-hospital mortality, and 20 (1.4%) developed symptomatic intracranial hemorrhage (sICH). Following propensity-score adjustment by IPTW accounting for age, stroke severity, and comorbidity burden, EVT was independently associated with favorable functional outcome [adjusted odds ratio (aOR) 1.25, 95% confidence interval (CI) 1.07, 1.46; p = 0.004], but not with in-hospital mortality or sICH. In an IPTW-adjusted sub-group analysis of patients with NIHSS scores >20, EVT was associated with both favorable functional outcome (discharge disposition to home or to acute rehabilitation) (aOR 1.55, 95% CI 1.24, 1.94; p < 0.001) and decreased mortality (aOR 0.78, 95% CI 0.69, 0.89; p < 0.001), but not with sICH.

Interpretation

This retrospective population-based analysis using a large national registry provides real-world evidence of a potential benefit of EVT in acute BAO patients.

Comments

© 2023 American Neurological Association.

https://onlinelibrary.wiley.com/share/JTCBPWVDBQCE9WD4BCRZ?target=10.1002/ana.26640

Recommended Citation

Dicpinigaitis, A.J., Dick-Godfrey, R., Gellerson, O., Shapiro, S.D., Kamal, H., Ghozy, S., Kaur, G., Desai, S.M., Ortega-Gutierrez, S., Yaghi, S., Altschul, D.J., Jadhav, A.P., Hassan, A.E., Nguyen, T.N., Brook, A.L., Mayer, S.A., Jovin, T.G., Nogueira, R.G., Gandhi, C.D. and Al-Mufti, F. (2023), Real-World Outcomes of Endovascular Thrombectomy for Basilar Artery Occlusion: Results of the BArONIS Study. Ann Neurol. https://doi.org/10.1002/ana.26640

Publication Title

Annals of Neurology

DOI

10.1002/ana.26640

Academic Level

faculty

Mentor/PI Department

Neurology