Basilar artery occlusion management: Specialist perspectives from an international survey

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00159816%3A_____%2F23%3A00079766" target="_blank" >RIV/00159816:_____/23:00079766 - isvavai.cz</a>

Alternative codes found

RIV/00216224:14110/23:00130696

Result on the web

<a href="https://onlinelibrary.wiley.com/doi/10.1111/jon.13084" target="_blank" >https://onlinelibrary.wiley.com/doi/10.1111/jon.13084</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1111/jon.13084" target="_blank" >10.1111/jon.13084</a>

Result language

angličtina

Original language name

Basilar artery occlusion management: Specialist perspectives from an international survey

Original language description

Background 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 &lt; .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 &gt; .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 &gt;= 10 (15.9% vs. 6.9%, p &lt; .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.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30210 - Clinical neurology

Project

Result was created during the realization of more than one project. More information in the Projects tab.

Continuities

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Publication year

2023

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Journal of Neuroimaging

ISSN

1051-2284

e-ISSN

1552-6569

Volume of the periodical

33

Issue of the periodical within the volume

3

Country of publishing house

US - UNITED STATES

Number of pages

12

Pages from-to

422-433

UT code for WoS article

000940458800001

EID of the result in the Scopus database

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