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Time Is Brain(stem) in Basilar Artery Occlusion.
MedLine Citation:
PMID:  22989501     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: The frequent use of a longer time window for recanalization therapy in patients with basilar artery occlusion (BAO) in daily practice is not supported by any scientific evidence. We investigated the relationship between time to recanalization therapy and functional outcome in BAO with data from the Basilar Artery International Cooperation Study (BASICS). METHODS: BASICS is a prospective multicenter registry of patients (n=619) with radiologically confirmed BAO. We analyzed patients receiving intravenous thrombolysis or intra-arterial treatment. Patients were divided into 4 groups based on the interval between estimated time of BAO and start of recanalization therapy: ≤3 hours (n=134), >3 to ≤6 hours (n=151), >6 to ≤9 hours (n=56), and >9 hours (n=68). Primary outcome measure was poor functional outcome (modified Rankin scale score 4-6) after 1 month. We calculated adjusted risk ratios with 95% CIs using Poisson regression analyses with the ≤3 hours group as the reference group. RESULTS: Patients had an increased risk of poor functional outcome as time to recanalization therapy became longer (≤3 hours: 62%; >3 to ≤6 hours: 67% [adjusted risk ratio, 1.06; 0.91-1.25]; >6 to ≤9 hours: 77% [adjusted risk ratio, 1.26; 1.06-1.51]; >9 hours: 85% [adjusted risk ratio, 1.47; 1.26-1.72]). CONCLUSIONS: Early recanalization therapy in patients with BAO is associated with a more favorable outcome with a significant increased chance of a poor outcome when recanalization therapy is started >6 hours after estimated time of BAO.
Authors:
Mervyn D I Vergouwen; Ale Algra; Thomas Pfefferkorn; Christian Weimar; Christina M Rueckert; Vincent Thijs; L Jaap Kappelle; Wouter J Schonewille;
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-18
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  -     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the UMC Utrecht Stroke Center, Department of Neurology and Neurosurgery, University Medical Center Utrecht and Rudolf Magnus Institute of Neurosciences, Utrecht, the Netherlands.
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