Interventions for hypertension and stroke

Coronary stent implantation for acute basilar artery occlusion with underlying stenosis

EuroIntervention 2020;16:e1021-e1028. DOI: 10.4244/EIJ-D-19-00519

Sándor Nardai
Sándor Nardai1,2, MD, PhD; Balázs Kis1, MD; István Gubucz1, MD; Zsolt Berentei1, MD, PhD; Zsolt Vajda1, MD; Péter Orosz1, MD; András Nagy1, MD, DSc; Csaba Óváry1, MD, PhD; Zoltán Nagy1,2, MD; István Szikora1, MD, PhD
1. Department Section of Neurointervention, Semmelweis University Department of Neurosurgery, National Institute of Clinical Neurosciences, Budapest, Hungary; 2. Department Section of Vascular Neurology, Semmelweis University Heart and Vascular Center, Budapest, Hungary

Aims: Our aim was to study the effectiveness of coronary stent implantation during the endovascular treatment (EVT) of acute basilar artery occlusion (BAO) with occlusion-underlying intracranial atherosclerotic stenosis (ICAS).

Methods and results: We retrospectively analysed 91 consecutive BAO patients who underwent EVT between February 2014 and January 2019 in a single, high-volume neurointerventional centre. We studied the effect of immediate coronary stent implantation on the clinical outcome of BAO with occlusion-underlying stenosis. BAO patients with underlying ICAS (n=41) were characterised by longer symptom-onset-to-reperfusion times (231 min vs 173 min, p=0.0020), lower TICI 2b-3 reperfusion rates (65.85% vs 90.00%, p=0.0084), and higher overall mortality (HR 2.021, p=0.0417) compared to the BAO cases without ICAS (n=50). The patients undergoing stenting (n=18) had lower residual basilar artery (BA) stenosis (14.7% vs 81.0%, p<0.0001), higher chance for functional recovery (OR 7.6, p=0.0250) and higher chance of survival (HR 4.163, p=0.0026) compared to the BAO-ICAS cases treated without coronary stents (n=21).

Conclusions: The immediate treatment of the occlusion-underlying stenosis with coronary stents and dual antiplatelet therapy (DAPT) in BAO was associated with improved overall survival and better functional outcomes.

Sign in to read and download the full article

Forgot your password?

No account yet?
Sign up for free!

Create my pcr account

Join us for free and access thousands of articles from EuroIntervention, as well as presentations, videos, cases from

ischaemic strokeStent retrieversthrombectomy
Interventions for strokeIschaemic strokeOther stroke interventions
Read next article
Usefulness of mean pulmonary artery pressure for predicting outcomes of transcatheter closure of atrial septal defect with pulmonary arterial hypertension

Latest news