Intended Bridging Therapy or Intravenous Thrombolysis Alone in Minor Stroke With Basilar Artery Occlusion
Pierre Seners, Cyril Dargazanli, Michel Piotin, Denis Sablot, Serge Bracard, Philippe Niclot, Jean‐Claude Baron, Guillaume Turc, Claire Perrin, Caroline Arquizan, Chantal Lamy, Igor Sibon, Michaël Obadia, Jérémie Papassin, Hilde Hénon, Cécile Preterre, Laurent Suissa, Séverine Debiais, Aïcha Lyoubi, Pierre Garnier, I. Girard-Buttaz, Bertrand Lapergue, Aude Triquenot, Duc-Long Duong, Nadia Laksiri, Gioia Mione, Jean‐Louis Mas
Abstract
Background and Purpose: Whether bridging therapy (intravenous thrombolysis [IVT] followed by mechanical thrombectomy) is superior to IVT alone in minor stroke with basilar artery occlusion remains uncertain. Methods: Multicentric retrospective observational study of consecutive minor stroke patients (National Institutes of Health Stroke Scale score ≤5) with basilar artery occlusion intended for IVT alone or bridging therapy. Propensity-score weighting was used to reduce baseline between-groups differences, and residual imbalance was addressed through adjusted logistic regression, with excellent outcome (3-month modified Rankin Scale score 0–1) as the dependent variable. Results: Fifty-seven patients were included (28 and 29 in the bridging therapy and IVT alone groups, respectively). Following propensity-score weighting, the distribution of baseline clinical and radiological variables was similar across the 2 patient groups, except age, posterior circulation Alberta Stroke Program Early CT Score, history of hypertension and smoking, and onset-to-IVT time. Compared with IVT alone, bridging therapy was associated with excellent outcome (adjusted odds ratio=3.37 [95% CI, 1.13–10.03]; P =0.03). No patient experienced symptomatic intracranial hemorrhage. Conclusions: Our results suggest that bridging therapy may be superior to IVT alone in minor stroke with basilar artery occlusion.