Basilar artery occlusion management: Specialist perspectives from an international survey-Reference-Cited by-同舟云学术

Basilar artery occlusion management: Specialist perspectives from an international survey

Published:2023-02-13 Issue:3 Volume:33 Page:422-433
ISSN:1051-2284
Container-title:Journal of Neuroimaging
language:en
Short-container-title:Journal of Neuroimaging

Author:

Edwards Christopher¹,Drumm Brian²^ORCID,Siegler James E.¹^ORCID,Schonewille Wouter J.³^ORCID,Klein Piers⁴^ORCID,Huo Xiaochuan⁵^ORCID,Chen Yimin⁶^ORCID,Abdalkader Mohamad⁴^ORCID,Qureshi Muhammad M.⁴⁷^ORCID,Strbian Daniel⁸^ORCID,Liu Xinfeng⁹¹⁰^ORCID,Hu Wei¹⁰^ORCID,Ji Xunming¹¹,Li Chuanhui¹²^ORCID,Fischer Urs¹³¹⁴^ORCID,Nagel Simon¹⁵¹⁶^ORCID,Puetz Volker¹⁷¹⁸^ORCID,Michel Patrik¹⁹^ORCID,Alemseged Fana²⁰^ORCID,Sacco Simona²¹^ORCID,Yamagami Hiroshi²²^ORCID,Yaghi Shadi²³^ORCID,Strambo Davide¹⁹^ORCID,Kristoffersen Espen Saxhaug²⁴²⁵^ORCID,Sandset Else C.²⁶^ORCID,Mikulik Robert²⁷^ORCID,Tsivgoulis Georgios²⁸^ORCID,Masoud Hesham E.²⁹,de Sousa Diana Aguiar³⁰^ORCID,Marto João Pedro³¹^ORCID,Lobotesis Kyriakos³²,Roi Dylan³²,Berberich Anne¹⁵,Demeestere Jelle³³^ORCID,Meinel Thomas R.¹³^ORCID,Rivera Rodrigo³⁴,Poli Sven³⁵³⁶^ORCID,Ton Mai Duy³⁷³⁸³⁹,Zhu Yuyou¹⁰,Li Fengli⁴⁰,Sang Hongfei⁴¹,Thomalla Götz⁴²^ORCID,Parsons Mark⁴³^ORCID,Campbell Bruce C. V.²⁰^ORCID,Zaidat Osama O.⁴⁴,Chen Hui‐Sheng⁴⁵^ORCID,Field Thalia S.⁴⁶^ORCID,Raymond Jean⁴⁷^ORCID,Kaesmacher Johannes⁴⁸^ORCID,Nogueira Raul G.⁴⁹^ORCID,Jovin Tudor G.¹,Sun Dapeng⁵,Liu Raynald⁵,Qureshi Adnan I.⁵⁰^ORCID,Qiu Zhongming³⁸⁵¹^ORCID,Miao Zhongrong⁵,Banerjee Soma²^ORCID,Nguyen Thanh N.⁴⁵²^ORCID

Affiliation:

1. Cooper Neurological Institute Cooper University Hospital Camden New Jersey USA

2. Department of Stroke Medicine, Imperial College Healthcare NHS Trust Charing Cross Hospital London UK

3. Department of Neurology St. Antonius Hospital Nieuwegein The Netherlands

4. Department of Radiology Boston Medical Center Boston Massachusetts USA

5. Department of Interventional Neuroradiology, Beijing Tiantan Hospital Capital Medical University Beijing China

6. Department of Neurology Foshan Sanshui District People's Hospital Foshan China

7. Radiation Oncology, Boston Medical Center Boston University Chobanian and Avedisian School of Medicine Boston Massachusetts USA

8. Department of Neurology Helsinki University Hospital Helsinki Finland

9. Department of Neurology Affiliated Jinling Hospital Medical School of Nanjing University Nanjing China

10. Stroke Center and Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine University of Science and Technology of China Hefei China

11. Department of Neurosurgery Xuanwu Hospital Capital Medical University Beijing China

12. Department of Neurology Xuanwu Hospital Capital Medical University Beijing China

13. Department of Neurology, Bern University Hospital University of Bern Bern Switzerland

14. Department of Neurology, Basel University Hospital University of Basel Basel Switzerland

15. Department of Neurology Klinikum Ludwigshafen Ludwigshafen am Rhein Germany

16. Department of Neurology Heidelberg University Hospital Heidelberg Germany

17. Department of Neurology, University Hospital Carl Gustav Carus Technische Universität Dresden Dresden Germany

18. Dresden Neurovascular Center, University Hospital Carl Gustav Carus Technische Universität Dresden Dresden Germany

19. Neurology Service, Department of Clinical Neurosciences Lausanne University Hospital and University of Lausanne Lausanne Switzerland

20. Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital University of Melbourne Parkville Victoria Australia

21. Neuroscience Section, Department of Biotechnological and Applied Clinical Sciences University of L'Aquila L'Aquila Italy

22. Department of Stroke Neurology National Hospital Organization, Osaka National Hospital Osaka Japan

23. Department of Neurology, Rhode Island Hospital Brown University Providence Rhode Island USA

24. Department of Neurology Akershus University Hospital Lørenskog Norway

25. Department of General Practice University of Oslo Oslo Norway

26. Department of Neurology The Norwegian Air Ambulance Foundation Oslo Norway

27. Department of Neurology, International Clinical Research Center, St Anne's University Hospital and Faculty of Medicine Masaryk University Brno Czech Republic

28. Second Department of Neurology Attikon University Hospital National and Kapodistrian University of Athens Athens Greece

29. Department of Neurology State University of New York Upstate Medical University Syracuse New York USA

30. Lisbon Central University Hospital and Faculdade de Medicina da Universidade de Lisboa Lisbon Portugal

31. Department of Neurology Hospital de Egas Moniz Centro Hospitalar Lisboa Ocidental Lisbon Portugal

32. Department of Radiology, Imperial College Healthcare NHS Trust Charing Cross Hospital London UK

33. Neurology Department Leuven University Hospital Leuven Belgium

34. Neuroradiology Department Instituto de Neurocirugia Dr. Asenjo Santiago Chile

35. Hertie Institute for Clinical Brain Research Eberhard‐Karls University Tübingen Germany

36. Department of Neurology & Stroke Eberhard‐Karls University Tübingen Germany

37. Stroke Center Bach Mai Hospital Hanoi Vietnam

38. Hanoi Medical University Hanoi Vietnam

39. Vietnam National University of Medicine and Pharmacy Hanoi Vietnam

40. Department of Neurology Xinqiao Hospital of the Army Medical University Chongqing China

41. Department of Neurology Affiliated Hangzhou First People's Hospital Zhejiang University School of Medicine Hangzhou China

42. Klinik und Poliklinik für Neurologie Universitätsklinikum Hamburg‐Eppendorf Hamburg Germany

43. Sydney Brain Center University of New South Wales Sydney New South Wales Australia

44. Neuroscience and Stroke Program Bon Secours Mercy Health St Vincent Hospital Toledo Ohio USA

45. Department of Neurology General Hospital of Northern Theatre Command Shenyang China

46. Department of Medicine, Division of Neurology University of British Columbia Vancouver British Columbia Canada

47. Neuroradiologie Interventionelle Centre Hospitalier de l'Universite de Montreal Montreal Quebec Canada

48. Department of Diagnostic and Interventional Neuroradiology University Hospital Bern Bern Switzerland

49. Department of Neurology University of Pittsburgh Medical Center Pittsburgh Pennsylvania USA

50. Department of Neurology The 903rd Hospital of The Chinese People's Liberation Army Hangzhou China

51. Zeenat Qureshi Stroke Institute and Department of Neurology University of Missouri Columbia Missouri USA

52. Department of Neurology Boston Medical Center Boston Massachusetts USA

Abstract

AbstractBackground and PurposeTwo early basilar artery occlusion (BAO) randomized controlled trials did not establish the superiority of endovascular thrombectomy (EVT) over medical management. While many providers continue to recommend EVT for acute BAO, perceptions of equipoise in randomizing patients with BAO to EVT versus medical management may differ between clinician specialties.MethodsWe conducted an international survey (January 18, 2022 to March 31, 2022) regarding management strategies in acute BAO prior to the announcement of two trials indicating the superiority of EVT, and compared responses between interventionalists (INTs) and non‐interventionalists (nINTs). Selection practices for routine EVT and perceptions of equipoise regarding randomizing to medical management based on neuroimaging and clinical features were compared between the two groups using descriptive statistics.ResultsAmong the 1245 respondents (nINTs = 702), INTs more commonly believed that EVT was superior to medical management in acute BAO (98.5% vs. 95.1%, p < .01). A similar proportion of INTs and nINTs responded that they would not randomize a patient with BAO to EVT (29.4% vs. 26.7%), or that they would only under specific clinical circumstances (p = .45). Among respondents who would recommend EVT for BAO, there was no difference in the maximum prestroke disability, minimum stroke severity, or infarct burden on computed tomography between the two groups (p > .05), although nINTs more commonly preferred perfusion imaging (24.2% vs. 19.7%, p = .04). Among respondents who indicated they would randomize to medical management, INTs were more likely to randomize when the National Institutes of Health Stroke Scale was ≥10 (15.9% vs. 6.9%, p < .01).ConclusionsFollowing the publication of two neutral clinical trials in BAO EVT, most stroke providers believed EVT to be superior to medical management in carefully selected patients, with most indicating they would not randomize a BAO patient to medical treatment. There were small differences in preference for advanced neuroimaging for patient selection, although these preferences were unsupported by clinical trial data at the time of the survey.

Publisher

Wiley

Subject

Neurology (clinical),Radiology, Nuclear Medicine and imaging

Link

https://onlinelibrary.wiley.com/doi/pdf/10.1111/jon.13084

Reference26 articles.

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