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Vertebral artery stenosis in the Basilar Artery International Cooperation Study (BASICS): prevalence and outcome

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Abstract

We assessed the prevalence of vertebral artery (VA) stenosis or occlusion and its influence on outcome in patients with acute basilar artery occlusion (BAO). We studied 141 patients with acute BAO enrolled in the Basilar Artery International Cooperation Study (BASICS) registry of whom baseline CT angiography (CTA) of the intracranial VAs was available. In 72 patients an additional CTA of the extracranial VAs was available. Adjusted risk ratios (aRRs) for death and poor outcome, defined as a modified Rankin Scale score ≥4, were calculated with Poisson regression in relation to VA occlusion, VA occlusion or stenosis ≥50 %, and bilateral VA occlusion. Sixty-six of 141 (47 %) patients had uni- or bilateral intracranial VA occlusion or stenosis ≥50 %. Of the 72 patients with intra- and extracranial CTA, 46 (64 %) had uni- or bilateral VA occlusion or stenosis ≥50 % and 9 (12 %) had bilateral VA occlusion. Overall, VA occlusion or stenosis ≥50 % was not associated with the risk of poor outcome. Patients with intra- and extracranial CTA and bilateral VA occlusion had a higher risk of poor outcome than patients without bilateral VA occlusion (aRR, 1.23; 95 % CI 1.02–1.50). The risk of death did not depend on the presence of unilateral or bilateral VA occlusion or stenosis ≥50 %. In conclusion, in patients with acute BAO, unilateral VA occlusion or stenosis ≥50 % is frequent, but not associated with an increased risk of poor outcome or death. Patients with BAO and bilateral VA occlusion have a slightly increased risk of poor outcome.

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Acknowledgments

The authors thank the BASICS study group and all health professionals from participating centres for their contribution to the BASICS registry [2]. AC, EJRJH, and HBW are supported by the Dutch Heart Foundation (2007/B045, 2010/B151, and 2010T075, respectively).

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Brain Centre Rudolf Magnus, Department of Neurology and Neurosurgery, G 03.232, University Medical Centre Utrecht, PO Box 85500, 3508, GA, Utrecht, The Netherlands

    Annette Compter, H. Bart van der Worp, L. Jaap Kappelle, Ale Algra & Wouter J. Schonewille

  2. Department of Radiology, St. Antonius Hospital, Nieuwegein, The Netherlands

    Erik J. R. J. van der Hoeven & Jan Albert Vos

  3. Department of Neurology, University of Duisburg-Essen, Essen, Germany

    Christian Weimar

  4. Department of Neurology, St Elisabeth Hospital, Ravensburg, Germany

    Christina M. Rueckert

  5. Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands

    Ale Algra

  6. Department of Neurology, St. Antonius Hospital, Nieuwegein, The Netherlands

    Wouter J. Schonewille

Authors
  1. Annette Compter
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  2. Erik J. R. J. van der Hoeven
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  3. H. Bart van der Worp
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  4. Jan Albert Vos
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  5. Christian Weimar
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  6. Christina M. Rueckert
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  7. L. Jaap Kappelle
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  8. Ale Algra
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  9. Wouter J. Schonewille
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Consortia

BASICS Study Group.

Corresponding author

Correspondence to Annette Compter.

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Appendix

Appendix

The following authors are part of the BASICS Study Group: Weber AM, Donnan GA, Thijs V, Peeters A, de Freitas G, Conforto AB, Miranda-Alves M, Massaro A, Ijäs P, Bogoslovsky T, Lindsberg PJ, Weimar C, Benemann J, Kraywinkel K, Haverkamp C, Michalski D, Weissenborn K, Goertler M, Kloth M, Bitsch A, Mieck T, Machetanz J, Möller P, Huber R, Kaendler S, Rueckert C, Audebert H, Müller R, Vatankhah B, Pfefferkorn T, Mayer TE, Szabo K, Disque C, Busse O, Berger C, Hacke W, Schwammenthal Y, Orion D, Tanne D, Bergui M, Pozzati E, Schonewille WJ, Algra A, Kappelle LJ, Luijckx GJ, Vroomen P, Vergouwen MD, Roos Y, Stam J, Bienfait P, de Leeuw FE, de Kort P, Dippel D, Pagola J, Ribo M, Molina C, Gonzales A, Gil-Peralta A, Norrving B, Arnold M, Fischer U, Gralla J, Mattle H, Schroth G, Michel P, Engelter ST, Wetzel S, Lyrer P, Grandjour J, Michael N, Baumgartner R, Tettenborn B, Hungerbuehler H, Baird T, Muir K, Wijman CA, Finley Caulfield A, Lansberg M, Schwartz N, Venkatasubramanian C, Garami Z, Bogaard S, Yatzu F, Grotta J.

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Compter, A., van der Hoeven, E.J.R.J., van der Worp, H.B. et al. Vertebral artery stenosis in the Basilar Artery International Cooperation Study (BASICS): prevalence and outcome. J Neurol 262, 410–417 (2015). https://doi.org/10.1007/s00415-014-7583-5

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  • DOI: https://doi.org/10.1007/s00415-014-7583-5

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