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ISC 2023 | Adjunctive intra-arterial thrombolysis in patients with basilar artery occlusion

Adnan Qureshi, MD, University of Missouri-Columbia, Columbia, MO, discusses the use of adjunctive intra-arterial thrombolysis (IAT) in patients with acute ischemic stroke due to basilar artery occlusion (BAO) undergoing mechanical thrombectomy. Increasing evidence suggests that IAT after mechanical thrombectomy may improve outcomes by tackling persistent occlusions in small blood vessels unreachable with mechanical devices. To investigate this in patients with BAO stroke, outcome and adverse event data was analyzed from the ATTENTION prospective, multicenter registry. Recanalization rates differed between the two groups, with significantly higher rates of mTICI grade 0-2b in the group who went on to receive IAT, compared to those who did not. Despite this, there was no difference in the likelihood of achieving a favorable outcome at 90 days, symptomatic intracranial hemorrhage rates within 72 hours, or death within 90 days. This analysis supports the safety in IAT in the BAO population, but further study is needed to evaluate the risk:benefit ratio and identify subgroups of patients more likely to benefit. This interview took place during the International Stroke Conference (ISC) 2023 in Dallas, TX.

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