Endovascular treatment versus standard medical treatment for vertebrobasilar artery occlusion (BEST): an open-label, randomised controlled trial

@article{Liu2020EndovascularTV,
  title={Endovascular treatment versus standard medical treatment for vertebrobasilar artery occlusion (BEST): an open-label, randomised controlled trial},
  author={Xinfeng Liu and Q. Dai and R. Ye and W. Zi and Yuxiu Liu and Huaiming Wang and Wusheng Zhu and Min-min Ma and Q. Yin and Min Li and Xin-ying Fan and Wen Sun and Yunfei Han and Qiushi Lv and Rui Liu and Dong Yang and Zhonghua Shi and D. Zheng and X. Deng and Y. Wan and Zhen Wang and Y. Geng and Xingyu Chen and Zhiming Zhou and Geng Liao and P. Jin and Yumin Liu and Xintong Liu and Meng Zhang and F. Zhou and Hongchao Shi and Yunfeng Zhang and Fuqiang Guo and Congguo Yin and Guozhong Niu and Mei-juan Zhang and Xue-hai Cai and Qiyi Zhu and Zhonglun Chen and Yingchun Liang and Bing Li and Min Lin and Wei Wang and Haowen Xu and Xin-Min Fu and Wen-hua Liu and X. Tian and Zi-li Gong and Haicun Shi and Chuanming Wang and P. Lv and Zhonghai Tao and Liangfu Zhu and Shi-quan Yang and Wei Hu and Ping Jiang and D. Liebeskind and V. Pereira and T. Leung and B. Yan and S. Davis and Ge-lin Xu and R. Nogueira and Y. Xiong and Zongjie Shi and Weihong Zheng and Xianjun Huang and Yong Liu and Huagang Li and Kaifu Ke and Shu Yang and Hang Lin and W. Dan and Lin Chen and Liangqun Rong and Shui-ping Wang and Jin Fan and Chengming Xing and Haifeng Li and Weimin Yang and Changqing Wang and Yong Zhang and Xiaobo Li},
  journal={The Lancet Neurology},
  year={2020},
  volume={19},
  pages={115-122}
}
BACKGROUND Previous randomised trials have shown an overwhelming benefit of mechanical thrombectomy for treating patients with stroke caused by large vessel occlusion of the anterior circulation. Whether endovascular treatment is beneficial for vertebrobasilar artery occlusion remains unknown. In this study, we aimed to investigate the safety and efficacy of endovascular treatment of acute strokes due to vertebrobasilar artery occlusion. METHODS We did a multicentre, randomised, open-label… Expand
Bridging versus direct endovascular therapy in basilar artery occlusion
TLDR
In ischaemic stroke due to BAO, when endovascular therapy is initiated within 6 hours from symptoms onset, bridging therapy resulted in lower mortality and better functional outcome compared with direct endov vascular therapy. Expand
Evaluation of Endovascular Treatment for Acute Basilar Occlusion in a State-Wide Prospective Stroke Registry
TLDR
In this prospective, quasi population-based registry of patients hospitalized with acute BAO, BMT plus EVT was not superior to BMT alone, and the results suggest that severely affected BAO patients are more likely to benefit from EVT. Expand
Mechanical Thrombectomy in Isolated Occlusion of the Proximal Posterior Cerebral Artery
Introduction: Endovascular therapy (EVT) is established as first-line treatment for acute ischemic stroke (AIS) due to large vessel occlusion (LVO) in the anterior circulation. For basilar arteryExpand
Assessment of Endovascular Treatment for Acute Basilar Artery Occlusion via a Nationwide Prospective Registry.
TLDR
Among patients with acute BAO, EVT administered within 24 hours of estimated occlusion time is associated with better functional outcomes and reduced mortality, and this nonrandomized cohort study was a nationwide prospective registry of consecutive patients presenting with an acute, symptomatic, radiologically confirmed BAO to 47 comprehensive stroke centers in China. Expand
Comparisons of characteristics and outcomes after mechanical thrombectomy for vertebrobasilar occlusion with cardioembolism or atherosclerotic brain infarction: Data from the Tokyo-tama-Registry of Acute Endovascular Thrombectomy (TREAT).
TLDR
Functional outcomes of VBA occlusion were not significantly different between CE and LAA, but patients with CE might have poorer collateral status than patients with LAA and earlier recanalization might therefore be desired. Expand
Endovascular treatment of acute basilar artery occlusion: Outcomes, influencing factors and imaging characteristics from the Tama-REgistry of acute thrombectomy (TREAT) study
TLDR
MT with modern devices for ABAO resulted in highly successful recanalization and good outcomes, with positive findings for the midbrain on diffusion-weighted imaging on pc-ASPECTS and brainstem score significantly associated with poor outcomes. Expand
Endovascular treatment versus standard medical treatment for acute basilar artery occlusion: protocol for a systematic review and meta-analysis
TLDR
A systematic review and meta-analysis is needed to evaluate the safety and efficacy of standard medical treatment and SMT plus endovascular thrombectomy for the treatment of acute basilar artery occlusion. Expand
Outcomes of Endovascular Thrombectomy for Basilar Artery Occlusion
TLDR
EvT appears to be safe and feasible in patients with BAO, and the finding that time to treatment and successful reperfusion were not associated with improved outcome is likely due to including patients with established infarcts. Expand
Current Status of Endovascular Treatment for Acute Large Vessel Occlusion in China
TLDR
Despite distinct characteristics in the Chinese population, favorable outcome of EVT can be achieved in clinical practice in China. Expand
Commentary on “Endovascular Therapy for Stroke Due to Basilar-Artery Occlusion”
  • K. Kreiser
  • Medicine
  • CardioVascular and Interventional Radiology
  • 2021
TLDR
A higher success rate for BMT can certainly be expected than in those with long occlusions, however, this deprives EVT of the chance to prove itself in a comparison. Expand
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