Andreas Bender

Caroline Ottomeyer

Christian Opherk

Gunther Fesl

Hartmut Brückmann

Judith Zeller

Markus Holtmannspötter

Martin Dichgans

Thomas Pfefferkorn


            Background and Purpose—
            Multimodal recanalization therapy in patients with acute basilar artery occlusion provides high recanalization rates. A substantial subset of treated patients survives with only minor or moderate functional handicap. However, long-term functional outcome and quality of life in these patients have rarely been systematically analyzed.
          
          
            Methods—
            In this monocentric retrospective study, we analyzed mortality, long-term functional outcome (modified Rankin Scale), and quality of life (36-Item Short-Form Health Survey questionnaire) in all consecutive patients who had been treated for acute basilar artery occlusion in our institution between December 2002 and December 2009.
          
          
            Results—
            
              Ninety-one patients (57 male; median age, 65 years; range, 20–89 years) were treated by multimodal recanalization therapy. This included intravenous thrombolysis (n=32) with consecutive on-demand intra-arterial therapy (n=23) or intra-arterial therapy alone (n=59). The overall recanalization rate was 89%. After a median observation time of 4.2 years (range, 0.5–7.4 years), the mortality rate was 59%. Among the 35 survivors, 26 patients (74%) had a good or moderate long-term functional outcome (modified Rankin Scale ≤3). Health-related quality of life was better than that of unselected patients with stroke. Backward stepwise logistic regression identified intravenous thrombolysis (
              P
              =0.002) and female sex (
              P
              =0.001) as predictors of favorable functional long-term outcome (modified Rankin Scale ≤3). Coma at admission (Glasgow Coma Scale ≤8) was associated with poor outcome (modified Rankin Scale ≥4;
              P
              =0.036).
            
          
          
            Conclusions—
            Long-term survival is achieved in approximately 40% of patients with basilar artery occlusion treated with multimodal recanalization therapy. Approximately 75% of the survivors have a favorable functional long-term outcome with an acceptable quality of life.
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Stroke

Multimodal Recanalization Therapy in Acute Basilar Artery Occlusion

Multimodal Recanalization Therapy in Acute Basilar Artery Occlusion

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