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Basilar artery occlusion management: specialist perspectives from an international survey

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dc.contributor.authorEdwards, Christopher
dc.contributor.authorDrumm, Brian
dc.contributor.authorSiegler, James E.
dc.contributor.authorSchonewille, Wouter J.
dc.contributor.authorKlein, Piers
dc.contributor.authorHuo, Xiaochuan
dc.contributor.authorChen, Yimin
dc.contributor.authorAbdalkader, Mohamad
dc.contributor.authorQureshi, Muhammad M.
dc.contributor.authorStrbian, Daniel
dc.contributor.authorLiu, Xinfeng
dc.contributor.authorHu, Wei
dc.contributor.authorJi, Xunming
dc.contributor.authorLi, Chuanhui
dc.contributor.authorFischer, Urs
dc.contributor.authorNagel, Simon
dc.contributor.authorPuetz, Volker
dc.contributor.authorMichel, Patrik
dc.contributor.authorAlemseged, Fana
dc.contributor.authorSacco, Simona
dc.contributor.authorYamagami, Hiroshi
dc.contributor.authorYaghi, Shadi
dc.contributor.authorStrambo, Davide
dc.contributor.authorKristoffersen, Espen Saxhaug
dc.contributor.authorSandset, Else C.
dc.contributor.authorMikulik, Robert
dc.contributor.authorTsivgoulis, Georgios
dc.contributor.authorMasoud, Hesham E.
dc.contributor.authorde Sousa, Diana Aguiar
dc.contributor.authorMarto, João Pedro
dc.contributor.authorLobotesis, Kyriakos
dc.contributor.authorRoi, Dylan
dc.contributor.authorBerberich, Anne
dc.contributor.authorDemeestere, Jelle
dc.contributor.authorMeinel, Thomas R.
dc.contributor.authorRivera, Rodrigo
dc.contributor.authorPoli, Sven
dc.contributor.authorTon, Mai Duy
dc.contributor.authorZhu, Yuyou
dc.contributor.authorLi, Fengli
dc.contributor.authorSang, Hongfei
dc.contributor.authorThomalla, Götz
dc.contributor.authorParsons, Mark
dc.contributor.authorCampbell, Bruce C. V.
dc.contributor.authorZaidat, Osama O.
dc.contributor.authorChen, Hui‐Sheng
dc.contributor.authorField, Thalia S.
dc.contributor.authorRaymond, Jean
dc.contributor.authorKaesmacher, Johannes
dc.contributor.authorNogueira, Raul G.
dc.contributor.authorJovin, Tudor G.
dc.contributor.authorSun, Dapeng
dc.contributor.authorLiu, Raynald
dc.contributor.authorQureshi, Adnan I.
dc.contributor.authorQiu, Zhongming
dc.contributor.authorMiao, Zhongrong
dc.contributor.authorBanerjee, Soma
dc.contributor.authorNguyen, Thanh N.
dc.date.accessioned2023-02-14T15:27:06Z
dc.date.available2023-02-14T15:27:06Z
dc.date.issued2023
dc.description© 2023 American Society of Neuroimaging.pt_PT
dc.description.abstractBackground and purpose: Two 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. Methods: We 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. Results: Among 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 < .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 > .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 ≥10 (15.9% vs. 6.9%, p < .01). Conclusions: Following 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.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Neuroimaging. 2023 Feb 13. doi: 10.1111/jon.13084pt_PT
dc.identifier.doi10.1111/jon.13084pt_PT
dc.identifier.eissn1552-6569
dc.identifier.issn1051-2284
dc.identifier.urihttp://hdl.handle.net/10451/56311
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.relation.publisherversionhttps://onlinelibrary.wiley.com/journal/15526569pt_PT
dc.subjectBasilar artery occlusionpt_PT
dc.subjectEndovascular therapypt_PT
dc.subjectIntravenous thrombolysispt_PT
dc.subjectMechanical thrombectomypt_PT
dc.titleBasilar artery occlusion management: specialist perspectives from an international surveypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleJournal of Neuroimagingpt_PT
person.familyNameAguiar de Sousa
person.familyNamede Seabra Marto
person.givenNameDiana
person.givenNameJoão Pedro
person.identifier574112
person.identifier.ciencia-id571C-121A-5CCB
person.identifier.ciencia-id991F-4D5C-7ED4
person.identifier.orcid0000-0002-6702-7924
person.identifier.orcid0000-0003-2277-5950
person.identifier.ridJ-4105-2013
person.identifier.scopus-author-id55781226000
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication1d984575-dd95-4ca1-9092-bf6f9914ba63
relation.isAuthorOfPublication2ec8439e-8c7e-4956-90eb-54a9caa22c15
relation.isAuthorOfPublication.latestForDiscovery2ec8439e-8c7e-4956-90eb-54a9caa22c15

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