Thrombolytic Therapy of Acute Basilar Artery Occlusion

Abstract

Background and Purpose Thrombolysis may reduce mortality after acute basilar artery (BA) occlusion. We intended to find variables affecting recanalization and clinical outcome in patients with BA occlusion undergoing thrombolytic therapy. Methods We analyzed in retrospect the clinical and angiographic data of a consecutive series of 51 patients treated with intra-arterial urokinase (n=44; 0.3 to 1.5 mIU) or intravenous or intra-arterial recombinant tissue plasminogen activator (n=7; 22 to 100 mg). We identified effective variables by multiple logistic regression analyses and univariate tests. Results Sites of occlusion were the caudal (n=23), middle (n=18), and distal (n=10) segments of the BA. The pathogenesis was embolism in 35 and local atherothrombosis in 16 patients. Collateral circulation was good in 32 patients and poor or absent in 19 patients. Recanalization was achieved in 26 of 51 (51%) patients and was associated with occlusions of embolic etiology (P=.0025). Mortality was 46% (12/26) in the r...