Clinicoradiological Features and Outcomes of Patients with Atherosclerotic Basilar Artery Steno-Occlusion: A Single-Center Experience

Abstract

Purpose: There is a relatively higher risk of peri-procedural stroke following elective stenting of patients with basilar artery (BA) occlusion compared with stenting of intracranial arteries. We sought to diagnose stroke risks in patients with BA steno-occlusive disease by describing their clinicoradiological features and by demonstrating that appropriate treatment would lead to favorable outcomes. Materials and Methods: A total of 92 patients who were treated from 2004 to 2016 for severe stenosis or occlusion of BA based on MR or CT angiography were enrolled in the study. We assessed clinical features, radiologic findings, and other clinical outcomes such as the degree of disability as determined by the modified Rankin Scale. Results: A total of 49 of the 92 patients (53.3%) had no relevant symptoms. The risk of a recurrent or new infarct in the relevant area was 4.59%/year. Following treatment, more than 50% of the 92 patients had favorable outcomes. A recurrent or new infarct was found in 9 (20.5%) of the 44 patients who had a poor prognosis. There was no significant difference between the two groups with respect to compromised circulation; however, the initial infarct (16 of 48 and 29 of 44, p = 0.002) was statistically significant between the two groups. Conclusion: Atherosclerotic BA steno-occlusion disease is associated with a relatively low risk of a recurrent or new infarct and with favorable clinical outcomes following appropriate medical treatment.

Keywords

• basilar artery
• atherosclerosis
• stenosis
• cerebral infarction
• medicine