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2023 Annual Meeting | C193 - Basilar Artery Occlusion: What Is New Is Old Again

Thursday 04/27/23
08:00 AM - 09:00 AM EST Add To Calendar
This program will be presented both in-person and online
This program will be available in the meeting's On Demand product.
Seminar
Fawaz Al-Mufti, MD
Cerebrovascular Disease and Interventional Neurology
Acute ischemic stroke is a leading cause of death and severe long-term disability. Basilar artery occlusions (BAO), which account for approximately 10% of large vessel strokes, confer especially poor outcomes, as severe deficits persist in 80% or more of patients following treatment and nearly 40% experience mortality. Although a preponderance of evidence had previously demonstrated equipoise between endovascular thrombectomy (EVT) and medical therapy alone for the treatment of acute BAO, recent randomized clinical trial data have, for the first time, demonstrated a clinical benefit to EVT in the posterior circulation. Past clinical trials evaluating endovascular therapy in BAO patients (BASICS and BEST) failed to demonstrate a clinical benefit to EVT, however these findings were met with methodological criticism due to patient crossover, poor recruitment rates, and potential dilution of treatment effect by inclusion of BAO of mild severity (which has not been established as a treatment indication for EVT in the anterior circulation). Data from the BAOCHE trial presented at the May 2022 European Stroke Organization Conference (ESOC) was the first evidence of a clinical benefit to EVT in BAO, demonstrating an improvement in mRS score of 0-3 at 90 days as well as a trend towards lower mortality rates in comparison with medical management alone. These results were followed shortly after by those of the ATTENTION trial, also presented at ESOC, which revealed a similar benefit of EVT to those of the BAOCHE trial in terms of functional status at 90 days and decreased mortality. These trials provided novel evidence for the efficacy of EVT in ischemic stroke of the posterior circulation.
1.00 CME credit
Patient Care & Procedural Skills, Medical Knowledge, Practice-based Learning and Improvement, Systems-based Practice, Quality Improvement
Advanced
Fellow, Resident, General Neurologist, Specialist Neurologist, Non-neurologist, Advanced Practice Provider, Neurohospitalist, Medical Student
Didactic, Audience Participation

Program Materials Program Evaluations

Event Timeline
08:00 AM - 08:01 AM EST Introduction Welcome and Introduction to the Basilar Artery Occlusion: What is New is Old Again
Fawaz Al-Mufti, MD, Gabor Toth, MD
08:01 AM - 08:10 AM EST Speaker Trials and Tribulations of Basilar Artery Occlusion Strokes
Fawaz Al-Mufti, MD
08:10 AM - 08:25 AM EST Speaker Endovascular Thrombectomy for Basilar Artery Occlusion — The BAOCHE Trial
Tudor G. Jovin, MD
08:25 AM - 08:40 AM EST Speaker The ATTENTION Trial: Endovascular Treatment for Acute Basilar Artery Occlusion
Raul G. Nogueira, MD
08:40 AM - 08:45 AM EST Speaker Real-world Outcomes of Endovascular Thrombectomy for Treatment of Acute Basilar Artery Occlusion: The BARONIS Study
Fawaz Al-Mufti, MD
08:45 AM - 09:00 AM EST Speaker Rescue Endovascular Stenting of Recalcitrant Basilar Artery Occlusion
Gabor Toth, MD
09:00 AM - 09:00 AM EST Closing Remarks Closing Remarks
Fawaz Al-Mufti, MD, Gabor Toth, MD
Faculty Disclosures
Fawaz Al-Mufti, MD Dr. Al-Mufti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Stryker. Dr. Al-Mufti has received personal compensation in the range of $0-$499 for serving as a Consultant for Cerenovus. Dr. Al-Mufti has received personal compensation in the range of $0-$499 for serving as a Consultant for Rapid Medical. Dr. Al-Mufti has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Revalesio .
Gabor Toth, MD Dr. Toth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Dynamed. Dr. Toth has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic.
Tudor G. Jovin, MD Dr. Jovin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerenovus. Dr. Jovin has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Contego Medical. Dr. Jovin has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Several law firms. Dr. Jovin has stock in Corindus. Dr. Jovin has stock in Methinks. Dr. Jovin has stock in Viz.ai. Dr. Jovin has stock in Route92. Dr. Jovin has stock in FreeOx Biotech. Dr. Jovin has stock in Galaxy. Dr. Jovin has stock in Kandu. The institution of Dr. Jovin has received research support from Stryker. The institution of Dr. Jovin has received research support from Medtronic.
Raul G. Nogueira, MD Dr. Nogueira has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for for advisory roles with Anaconda, Biogen, Cerenovus, Genentech, Hybernia, Imperative Care, Medtronic, Phenox, Philips, Prolong Pharmaceuticals, Stryker Neurovascular, Shanghai Wallaby, and Synchron (consulting fees) as well as for advisory roles with Astrocyte, Brainomix, Cerebrotech, Ceretrieve, Corindus Vascular Robotics, Vesalio, Viz-AI, RapidPulse and Perfuze ( stock options). Dr. Nogueira has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Law Firms. Dr. Nogueira has received stock or an ownership interest from Viz-AI, Perfuze, Cerebrotech, Reist/Q'Apel Medical, Truvic, and Viseon. The institution of Dr. Nogueira has received research support from Cerenovus.