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Background
The therapeutic efficacy of low-dose intravenous alteplase (0.6 mg/kg) for basilar artery occlusion (BAO) remains unknown.
Methods
BAO patients enrolled from the Japanese multicenter registry involving 600 stroke patients treated with the low-dose intravenous alteplase were studied.
Results
Twenty-five patients had BAO (8 women ranging from 32-92 years of age; mean baseline National Institutes of Health Stroke Scale [NIHSS] score 16). The stroke subtype was cardioembolic in 15 patients and atherothrombotic in 4 patients. BAO was recanalized during hospitalization in 18 (78 % ) of 23 patients undergoing follow-up angiography. Within the initial 24 hours, 14 patients (56 % ) had a ¡Ý8-point decrease in the NIHSS score, being more common than 267 patients with middle cerebral artery occlusion (MCO) from the same registry (odds ratio [OR] 2.50; 95 % confidence interval [CI] 1.06-5.97) after adjustment by sex, age, and baseline NIHSS score. In addition, 4 patients (16 % ) had a ¡Ý4-point increase in the score, being marginally more common than MCO patients (OR 3.13; 95 % CI 0.81-10.25). Symptomatic intracranial hemorrhage within the initial 36 hours (8 % v 5 % ), independence at 3 months (modified Rankin Scale score ¡Ü2, 48 % v 52 % ), and mortality at 3 months (4 % v 6 % ) were similar when comparing BAO and MCO patients. When compared with previous studies of BAO, vital and functional outcomes at 3 months were relatively better in our study.
Conclusions
The use of low-dose alteplase resulted in similar outcomes when comparing acute BAO and MCO patients.
