Basilar artery occlusion carries high morbidity and mortality. In patients who present within 24 hours of symptom onset with a specific clinical and imaging profile, evidence-based guidelines support a defined acute intervention strategy aimed at restoring blood flow and improving functional outcomes.
Acute ischemic stroke due to basilar artery occlusion in patients with a baseline modified Rankin Scale (mRS) score of 0 to 1, an NIHSS score of 10 or greater at presentation, and a PC-ASPECTS score of 6 or higher — all presenting within 24 hours from onset of symptoms.
An endovascular thrombectomy (EVT) approach initiated within 24 hours from symptom onset is recommended for eligible patients in this clinical profile, with the objective of achieving reperfusion on angiography.
Specific technique selection, procedural algorithm, and reperfusion targets are outlined in the complete protocol.
In patients with AIS, with basilar artery occlusion, a baseline mRS score of 0 to 1, NIHSS score ≥10 at presentation, and PC-ASPECTS ≥6 (mild ischemic damage), EVT within 24 hours from onset of symptoms is recommended to achieve better functional outcome and reduce mortality.
In patients with AIS undergoing EVT, reperfusion to an extended TICI grade 2b/2c/3 is recommended as early as possible within the therapeutic window to achieve maximum functional benefit at 90 days.
DOI: 10.1161/STR.0000000000000513 View source ↗