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Trial of Endovascular Treatment of Acute Basilar-Artery Occlusion

By Currents Editor posted 10-26-2022 23:00

  

New England Journal of Medicine (10/13/22) DOI: 10.1056/NEJMoa2206317

Tao, Chunrong; Nogueira, Raul G.; Zhu, Yuyou; et al.

https://www.nejm.org/doi/full/10.1056/NEJMoa2206317

New research shows that for patients who experienced a basilar arterial occlusion, an endovascular thrombectomy in 12 hours was linked to improved functional outcomes at 90 days compared with best medical care. The prospective ATTENTION trial, conducted at 36 centers in China, randomized patients who were within 12 hours of the estimated time of basilar-artery occlusion to receive endovascular thrombectomy or best medical care. Of the 340 patients in the intention-to-treat population, 226 were assigned to the thrombectomy group and 114 served as controls. In all, 31% and 34%, respectively, of the patients received I.V. thrombolysis. At 90 days, 46% (104 patients) of the thrombectomy group and 23% (26) of the control group had attained the good functional status, defined as a score of 0 to 3 on the modified Rankin scale — the primary outcome. Symptomatic intracranial hemorrhage occurred more frequently in the thrombectomy group, affecting 5% (12 patients) vs. none in the control group. Mortality rates for the two groups at 90 days were 37% and 55%. Additionally, 14% of the thrombectomy group experienced procedural complications, including six arterial dissections, five vessel perforations, and one death due to arterial perforation.

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