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Cited by 717Acute Ischemic Stroke ManagementCerebrovascular and Carotid Artery DiseasesIntracranial Aneurysms: Treatment and Complications

The DOI matches its Crossref record; 23 of the 23 references it cites were found in a registry or an index.

Trial of Endovascular Treatment of Acute Basilar-Artery Occlusion

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Tao, Chunrong, Nogueira, Raul G., Zhu, Yuyou, Sun, Jun, Han, Hongxing, Yuan, Guangxiong, Wen, Changming, Zhou, Peiyang, Chen, Wenhuo, Zeng, Guoyong, Li, Yuwen, Ma, Zhengfei, Yu, Chuanqing, Su, Junfeng, Zhou, Zhiming, Chen, Zhongjun, Liao, Geng, Sun, Yaxuan, Ren, Youquan, Zhang, Hui, Chen, Jie, Yue, Xincan, Xiao, Guodong, Wang, Li, Liu, Rui, Liu, Wenhua, Liu, Yong, Wang, Li, Zhang, Chao, Liu, Tianlong, Song, Jianlong, Li, Rui, Xu, Pengfei, Yin, Yamei, Wang, Guoping, Baxter, Blaise, Qureshi, Adnan I., Liu, Xinfeng, Hu, Wei·2022·New England Journal of Medicine
DOI 10.1056/nejmoa2206317
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Abstract

BACKGROUND: Data from trials investigating the effects and risks of endovascular thrombectomy for the treatment of stroke due to basilar-artery occlusion are limited. METHODS: We conducted a multicenter, prospective, randomized, controlled trial of endovascular thrombectomy for basilar-artery occlusion at 36 centers in China. Patients were assigned, in a 2:1 ratio, within 12 hours after the estimated time of basilar-artery occlusion to receive endovascular thrombectomy or best medical care (control). The primary outcome was good functional status, defined as a score of 0 to 3 on the modified Rankin scale (range, 0 [no symptoms] to 6 [death]), at 90 days. Secondary outcomes included a modified Rankin scale score of 0 to 2, distribution across the modified Rankin scale score categories, and quality of life. Safety outcomes included symptomatic intracranial hemorrhage at 24 to 72 hours, 90-day mortality, and procedural complications. RESULTS: Of the 507 patients who underwent screening, 340 were in the intention-to-treat population, with 226 assigned to the thrombectomy group and 114 to the control group. Intravenous thrombolysis was used in 31% of the patients in the thrombectomy group and in 34% of those in the control group. Good functional status at 90 days occurred in 104 patients (46%) in the thrombectomy group and in 26 (23%) in the control group (adjusted rate ratio, 2.06; 95% confidence interval [CI], 1.46 to 2.91, P<0.001). Symptomatic intracranial hemorrhage occurred in 12 patients (5%) in the thrombectomy group and in none in the control group. Results for the secondary clinical and imaging outcomes were generally in the same direction as those for the primary outcome. Mortality at 90 days was 37% in the thrombectomy group and 55% in the control group (adjusted risk ratio, 0.66; 95% CI, 0.52 to 0.82). Procedural complications occurred in 14% of the patients in the thrombectomy group, including one death due to arterial perforation. CONCLUSIONS: In a trial involving Chinese patients with basilar-artery occlusion, approximately one third of whom received intravenous thrombolysis, endovascular thrombectomy within 12 hours after stroke onset led to better functional outcomes at 90 days than best medical care but was associated with procedural complications and intracerebral hemorrhage. (Funded by the Program for Innovative Research Team of the First Affiliated Hospital of USTC and others; ATTENTION ClinicalTrials.gov number, NCT04751708.).

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Authors
Tao, C., Nogueira, R. G., Zhu, Y., Sun, J., Han, H., Yuan, G., Wen, C., Zhou, P., Chen, W., Zeng, G., Li, Y., Ma, Z., Yu, C., Su, J., Zhou, Z., Chen, Z., Liao, G., Sun, Y., Ren, Y., Zhang, H., Chen, J., Yue, X., Xiao, G., Wang, L., Liu, R., Liu, W., Liu, Y., Wang, L., Zhang, C., Liu, T., Song, J., Li, R., Xu, P., Yin, Y., Wang, G., Baxter, B., Qureshi, A. I., Liu, X., & Hu, W.
Affiliations
  • University of Science and Technology of China (CN)
  • Wannan Medical College (CN)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2022-10-13
Volume
387
Issue
15
Pages
1361-1372
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa2206317
OpenAlex
W4304808118
Cited by
699
References
23
Citations by year
2026: 146 · 2025: 168 · 2024: 201 · 2023: 162 · 2022: 21
FWCI
99.63
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cerebrovascular and Carotid Artery Diseases
  • Health Sciences › Medicine › Clinical Neurology › Intracranial Aneurysms: Treatment and Complications
Keywords
basilar artery occlusion, acute ischemic stroke, intravenous thrombolysis, functional outcome, modified Rankin Scale, symptomatic intracranial hemorrhage, 90-day mortality, procedural complications, Chinese patients, arterial perforation, quality of life
MeSH terms
Arterial Occlusive Diseases, Basilar Artery, Brain Ischemia, Fibrinolytic Agents, Humans, Prospective Studies, Quality of Life, Thrombolytic Therapy, Treatment Outcome, Thrombectomy, Recovery of Function, Intracranial Hemorrhages, Stroke, Endovascular Procedures, Administration, Intravenous

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