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Abstract Details

Endovascular Thrombectomy with and without Bridging Intravenous Tissue Plasminogen Activator in Acute Ischemic Stroke Patients with Basilar Artery Occlusion
Cerebrovascular Disease and Interventional Neurology
Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)
032
We aimed to determine if patients who received bridging intravenous tissue Plasminogen Activator (IV-tPA) therapy treatment prior to endovascular thrombectomy (ET) had better outcomes compared to patients who received ET alone.
ET is increasingly being performed in patients who present with basilar artery occlusion (BAO) acute ischemic stroke. In patients with BAO who undergo ET, it is unclear whether prior treatment with bridging IV-tPA confers any benefit. 

In this real-world patient registry, we performed a retrospective analysis of all patients with BAO who had undergone ET across 5 centres internationally (1 in Singapore, 1 in UK, and 3 in Germany) between 2015 and 2019. Outcome measures included the discharge modified Rankin Score (mRS) of 0-2, in-hospital mortality, and symptomatic intracranial haemorrhage (sICH). Multivariable logistic regression was used to compare outcomes of patients who had received bridging IV-tPA and ET versus those who received primary ET alone.
Of 212 consecutive patients analysed, 101 (47.6%) underwent bridging IV-tPA treatment prior to ET and 111 (52.4%) underwent primary ET alone without bridging IV-tPA. Both groups were similar in baseline characteristics including age, admission National Institute of Health Stroke Scale (NIHSS) score and comorbidity profile. Both groups had similar rates of good functional outcome measured by mRS at 3-months (mRS 0 – 2 in 26.9% vs 21.1% in bridging tPA group and primary ET group respectively; OR = 1.38; CI = 0.72–2.63; p = 0.34), rates of in-hospital mortality (24.5% vs 33.3%; OR = 0.65; CI = 0.35–1.20; p = 0.17), and sICH (4.5% vs 4.9%; OR = 0.92; CI = 0.20–4.25; p = 0.91).

In patients with acute ischemic stroke due to BAO, the use of bridging IV-tPA treatment prior to ET is not associated with improved outcomes. Randomized controlled trials are warranted to investigate this further.  
Authors/Disclosures
Isabel Siow
PRESENTER 		Ms. Siow has nothing to disclose.
No disclosure on file
No disclosure on file
No disclosure on file
Bernard P. Chan, MD (National University Hospital) The institution of Dr. Chan has received research support from National University Hospital, Singapore.
Vijay Sharma No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
Benjamin Yong Qiang Tan Benjamin Yong Qiang Tan has nothing to disclose.
Leonard L. Yeo, MBBS (NUHS) The institution of Dr. Yeo has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Astrazeneca. The institution of Dr. Yeo has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for stryker. Dr. Yeo has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for NUHS. Dr. Yeo has received stock or an ownership interest from cereflo. The institution of Dr. Yeo has received research support from NMRC.