[Sportschosun reporter Jang Jong-ho] A study has found that thrombectomy can help reduce the death rate in patients with basilar artery occlusion, a condition in which a major blood vessel at the back of the brain becomes blocked, even if they do not meet the criteria used in previous clinical trials.
A research team led by Professor Lee Jeong-yun analyzed 1,012 patients with basilar artery occlusion among 49,471 acute ischemic stroke patients registered in the Korea Clinical Research Center Stroke Registry from January 2011 to December 2021. The registry involved more than 20 university hospitals nationwide. The team classified patients into eligible and ineligible groups based on two internationally recognized major clinical trial criteria and compared the effects of endovascular treatment.
The study found that only 24% of patients, or 246 people, met the first trial criterion, which required treatment within 12 hours of symptom onset. Just 6%, or 65 patients, met the second criterion, which covered 6 to 24 hours after onset. The remaining 72%, or 727 patients, met neither standard. Endovascular treatment was performed in 75% of patients who met the first criterion, 59% of those who met the second, and 43% of those who were ineligible under both trials.
Among patients who met the first trial criterion, endovascular treatment improved functional outcomes at three months and reduced mortality by 48%. In the group that met the second criterion, the sample size was too small to reach statistical significance, although a trend toward benefit was observed.
Notably, even among patients who did not meet either trial criterion, thrombectomy was significantly associated with lower mortality. After adjustment, the procedure was found to lower the three-month risk of death by about 23% in these patients. Some functional recovery measures did not reach statistical significance, but the survival benefit was consistently observed.
Professor Lee Jeong-yun of the Department of Neurology at Soonchunhyang University Seoul Hospital said, "Through this study, we confirmed that a substantial number of patients with basilar artery occlusion in real-world practice are not included in existing clinical trial criteria." He added, "Going forward, we will work to develop more objective and practical treatment selection criteria so that more patients can receive appropriate care."
Meanwhile, the paper by Professor Lee's team, titled "Real-world effectiveness of thrombectomy for basilar artery occlusion: lessons beyond the ATTENTION and BAOCHE trials," was published in May in the European Stroke Journal, the official journal of the European Stroke Organisation.
Jang Jong-ho, bellho@sportschosun.com
This article has been translated by GripLabs Mingo AI.
