MSc projects 1819 001

Functional outcome of basilar artery occlusion: systematic review & meta-analysis.

Abstract:
  • Introduction: Basilar artery occlusion (BAO) is one of the most devastating forms of stroke. Survival and functional outcome associated with BAO is bleak. Conservative treatment of BAO is associated with a high mortality (> 85%). Outcomes following IV thrombolysis in BAO are also poor with favourable functional outcome < 25% and mortality rate of 40%. Mechanical thrombectomy may offer improved functional outcome and reduced mortality.
  • Aim: To carry out a systematic review assessing the functional outcome of mechanical thrombectomy in patients with basilar artery occlusion. Primary outcomes measured in this study include, favourable outcome and mortality rate with complication rate as a secondary outcome measurement.
  • Method: A systematic review of all original studies measuring the functional outcome of BAO with mechanical thrombectomy as treatment up to December 2018.
  • Results: The final analysis included 49 papers with 1968 patients. The weighted mean age was 61 years (range 54 -71) and 61% male. The favourable functional outcome at 90 days was 37% (95% CI 35%–40%; I2 = 31.6%). Mortality at 90 days was 28% (95% CI 24%–32%; I2 = 64.9%). The complication of symptomatic intracranial haemorrhage was 6% (95% CI 4%–9%; I2 = 64.1%).
  • Conclusion: This study has demonstrated the significance of mechanical thrombectomy for the treatment of BAO. Mechanical thrombectomy appears to be the favorable for BAO when compared to previously published outcomes of best medical management.
Project type:
  • Systematic review
  • Meta-analysis
Imaging keywords:
  • Digital subtraction angiography (DSA)
  • Interventional neuroradiology
Application / disease keywords:
  • Stroke
  • Thrombectomy, mechanical
  • Occlusion, basilar artery (BAO)
Supervisor(s):
Programme:
Year:
  • 18-19