ISC 2023 | Managing basilar artery occlusion: stroke provider perspectives

Basilar artery occlusions (BAOs) are a rare form of acute poster circulation stroke, associated with high morbidity and mortality. Until recently, the best management approach in cases of BAO was uncertain. Data from the BEST (NCT02441556) and BASICS trials suggested no evidence of a difference in functional outcomes in patients treated with endovascular treatment (EVT) versus standard medical therapy. However, both trials had issues with crossover and poor recruitment, necessitating further robust trial data to shed light on BAO EVT. In 2022, BAOCHE (NCT02737189) and ATTENTION (NCT04751708) studied thrombectomy in the 6- to 24-hour time window and 0- to 12-hour time window, respectively, findings a higher rate of good functional outcome at 90 days, compared to medical management alone. James E. Siegler, MD, Cooper Neurological Institute, Cooper University Hospital, Camden, NJ, talks on the use of EVT in BAO management, sharing the findings of an international survey regarding preferred management strategies. Conducted prior to the announcement of BAOCHE and ATTENTION, more than 90% of stroke providers believed EVT to be superior to medical management. The new trial data support these preferences. This interview took place during the International Stroke Conference (ISC) 2023 in Dallas, TX.

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