UNASSIGNED: The study was a post hoc analysis of the ATTENTION trial (Trial of Endovascular Treatment of Acute Basilar-Artery Occlusion), which was a multicenter, randomized trial at 36 centers in China from February 2021 to September 2022. Patients with acute BAO were classified into 3 groups according to stroke etiology (large-artery atherosclerosis [LAA], cardioembolism, and undetermined cause/other determined cause [UC/ODC]). The primary outcome was a favorable outcome (modified Rankin Scale score of 0-3) at 90 days. Safety outcomes included symptomatic intracranial hemorrhage and 90-day mortality.
UNASSIGNED: A total of 340 patients with BAO were included, 150 (44.1%) had LAA, 72 (21.2%) had cardioembolism, and 118 (34.7%) had UC/ODC. For patients treated with BMT plus EVT and BMT alone, respectively, the rate of favorable outcome at 90 days was 49.1% and 23.8% in the LAA group (odds ratio, 3.08 [95% CI, 1.38-6.89]); 52.2% and 30.8% in the cardioembolism group (odds ratio, 2.45 [95% CI, 0.89-6.77]); and 37.5% and 17.4% in the UC/ODC group (odds ratio, 2.85 [95% CI, 1.16-7.01]), with P=0.89 for the stroke etiology×treatment interaction. The rate of symptomatic intracranial hemorrhage in EVT-treated patients with LAA, cardioembolism, and UC/ODC was 8.3%, 2.2%, and 3.2%, respectively, and none of the BMT-treated patients. Lower 90-day mortality was observed in patients with EVT compared with BMT alone across 3 etiology groups.
UNASSIGNED: Among patients with acute BAO, EVT compared with BMT alone might be associated with favorable outcomes and lower 90-day mortality, regardless of cardioembolism, LAA, or UC/ODC etiologies. The influence of stroke etiology on the benefit of EVT should be explored by further trials.
UNASSIGNED: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04751708.
■该研究是对注意试验(急性基底动脉阻塞的血管内治疗试验)的事后分析,这是一个多中心,2021年2月至2022年9月在中国36个中心进行的随机试验。急性BAO患者根据卒中病因分为3组(大动脉粥样硬化[LAA],心脏栓塞,和未确定原因/其他确定原因[UC/ODC])。主要结果是90天的有利结果(改良的Rankin量表评分为0-3)。安全性结果包括症状性颅内出血和90天死亡率。
■共纳入340例BAO患者,150人(44.1%)有左心耳,72人(21.2%)有心源性栓塞,118例(34.7%)患有UC/ODC。对于接受BMT加EVT和仅接受BMT治疗的患者,分别,LAA组90天时的有利结局率分别为49.1%和23.8%(比值比,3.08[95%CI,1.38-6.89]);心栓塞组为52.2%和30.8%(比值比,2.45[95%CI,0.89-6.77]);UC/ODC组的37.5%和17.4%(比值比,2.85[95%CI,1.16-7.01]),卒中病因×治疗交互作用P=0.89。EVT治疗的LAA患者的症状性颅内出血率,心脏栓塞,UC/ODC为8.3%,2.2%,和3.2%,分别,也没有接受BMT治疗的患者.在3个病因组中,与单独的BMT相比,EVT患者的90天死亡率较低。
■在急性BAO患者中,与单独的BMT相比,EVT可能与有利的结果和更低的90天死亡率相关。不管心脏栓塞,LAA,或UC/ODC病因。卒中病因对EVT益处的影响应通过进一步的试验来探索。
■URL:https://www。clinicaltrials.gov;唯一标识符:NCT04751708。