TY - JOUR T1 - Endovascular treatment for basilar artery occlusion: a meta-analysis JF - Stroke and Vascular Neurology JO - Stroke Vasc Neurol SP - 1 LP - 3 DO - 10.1136/svn-2022-001740 VL - 8 IS - 1 AU - Jiawen Xu AU - Xi Chen AU - Shidong Chen AU - Wenjie Cao AU - Hongchen Zhao AU - Wei Ni AU - Yanrong Zhang AU - Chao Gao AU - Yuxiang Gu AU - Xin Cheng AU - Yi Dong AU - Qiang Dong Y1 - 2023/02/01 UR - http://svn.bmj.com/content/8/1/1.abstract N2 - Acute basilar artery occlusion (BAO) may lead to severe disability or death in about 70% of patients.1 2 Previous studies have established endovascular treatment (EVT) as the standard treatment for patients with acute anterior circulation occlusions.3–9 However, the ideal effective treatment for acute BAO remains controversial.Two previously published randomised control studies (RCTs), BEST (Basilar Artery Occlusion Endovascular Intervention versus Standard Medical Treatment) and BASICS (Basilar Artery International Cooperation Study), failed to achieve an advantage of EVT over standard medical treatment (SMT) .10 11 Recently, two other RCTs from China, ATTENTION (Endovascular Treatment For Acute Basilar Artery Occlusion: A Multicentre Randomised Clinical Trial) and BAOCHE (Basilar Artery Occlusion Chinese Endovascular), were presented at the European Stroke Organisation Conference 2022.12 13 The ATTENTION trial showed that EVT was associated with the better functional outcomes at 90 days, achieving a higher rate of modified Rankin Scale (mRS) score of ≤3 (46.0% vs 22.8%; adjusted relative risk (aRR) 2.1, 95% CI 1.5 to 3.0, p<0.001; number needed to treat (NNT)=4) and mRS≤2 (33.2% vs 10.5%; aRR 3.2, 95% CI 1.8 to 5.4, p<0.001; NNT=4.4). There was also a significantly lower risk of 90-day mortality (36.7% vs 55.3%; aRR 0.7, 95% CI 0.5 to 0.8, p<0.001; NNT=5.4) but a higher incidence of symptomatic intracranial haemorrhage (sICH, Safe Implementation of Thrombolysis in Stroke—Monitoring Study (SITS-MOST) criteria, EVT 5.3% vs SMT 0%, p=0.001; NNT=19). Likewise, the BAOCHE trial demonstrated that patients receiving EVT had a higher rate of mRS 0–3 (46.4% vs 24.3%, adjusted OR 2.92, 95% CI 1.56 to 5.47, p=0.001; NNT=4.5), trends towards lower mortality (EVT 30.9% vs SMT 42.1%, p=0.088) and a higher risk of sICH (SITS-MOST criteria, EVT 5.9% vs SMT 1.1%, p=0.125). These findings showed the efficacy of EVT, which could be a turning point for the treatment of acute … ER -