Abstract Number: Esoc2026a699 Role of Thrombectomy Technique in Bridging Intravenous Thrombolysis for Basilar Artery Occlusion
Year: 2026
Type: conference-abstract
Abstract: Background and aims Endovascular treatment (EVT) is the standard of carefor acute basilar artery occlusion (BAO) although the role of bridging intravenous thrombolysis (IVT) prior to EVT remains debated. Whether the effect of bridging IVT differs across EVT techniques has not been systematically assessed. Methods We conducted a retrospective multicentre analysis including consecutive BAO patients treated with EVT at seven comprehensive stroke centres between 2019 and 2023. Patients were stratified according to first-line thrombectomy technique: direct thromboaspiration (BAOTHROMBOASPIRATION), stent retriever (BAOSTENT), or combined approach (BAOCOMBINED). Outcomes were analysed using inverse probability weighting to adjust for baseline imbalances. The primary endpoint was 90-day functional independence (mRS 0–3) and ordinal 90-day mRS shift. Secondary endpoints included 90-day excellent outcome, successful reperfusion, 90-day mortality, haemorrhagic transformation, and symptomatic intracerebral haemorrhage (sICH). Sensitivity analyses with trimmed weights and subgroup analyses were prespecified. Results A total of 517 patients were included: 200 BAOTHROMBOASPIRATION, 260 BAOSTENT and 57 BAOCOMBINED. In BAOTHROMBOASPIRATION patients, bridging IVT was associated with higher rates of favourable outcome (RR 1.47, 95% CI 1.00–2.16) and improved 90-day mRS shift. In BAOSTENT patients bridging IVT significantly reduced sICH risk (RR 0.27, 95% CI 0.09–0.77) while in BAOCOMBINED patients increased 90-day functional independence (RR 1.91, 95% CI 1.08–3.36). Results were consistent in sensitivity analyses. Conclusions The impact of bridging IVT in BAO varies across thrombectomy techniques but consistently trends toward benefit. These findings suggest that the role of bridging IVT should also be interpreted in light of the procedural context. Conflict of interest SB is a key opinion leader for RAPIDAI. TNN is Associate Editor of Stroke; advisory board for Brainomix, Aruna Bio; speaker for Genentech, Kaneka. RS is partially funded by the UCLH Biomedical Research Centre. All other authors have no conflicts of interests. Figure 1 - belongs to Results
Source: European Stroke Journal
Authors: Gabriele Prandin, Mohammed Jaffar, Ahmed Kazi, Samir Abu Rumeileh, Markus Otto, Lorenzo Barba, Thanh N Nguyen, Mohamad Abdalkader, Piers Klein, Kyriakos Lobotesis, Mariarosaria Valente, Gian Luigi Gigli, Soumik Talukder, Liqun Zhang, Matteo Foschi, Giovanni Merlino, Rob Simister, Soma Banerjee, Lucio D'anna
Institutions: University of Trieste, Azienda sanitaria universitaria Giuliano Isontina, Imperial College London, Martin Luther University Halle-Wittenberg, Boston Medical Center, National Health Service, Imperial College Healthcare NHS Trust, Charing Cross Hospital, University of Udine, St George's Hospital, St George's, University of London, University of L'Aquila, University College Hospital, University College London Hospitals NHS Foundation Trust, University College London
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,400
OpenAlex ID: W7160408598
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