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November 30, 2021; 97 (22) Research Article

Association Between Time to Endovascular Therapy and Outcomes in Patients With Acute Basilar Artery Occlusion

Hong Fei Sang, Jun Jie Yuan, View ORCID ProfileZhong Ming Qiu, Min Zhang, Xiao Gang Hu, Wen Hua Liu, Ning Wang, Hong Xing Han, Tie Yu Tang, Guo Yong Zeng, Hui Dong, Xing Min Long, Ling Fei Li, Feng Li Li, Shuai Liu, Wei Dong Luo, Jia Cheng Huang, Jia Xing Song, Lin Yu Li, Lu Ming Chen, Dong Jing Xie, De Ping Wu, Fang Fei Li, Wen Jie Zi, View ORCID ProfileQing Wu Yang
First published October 14, 2021, DOI: https://doi.org/10.1212/WNL.0000000000012858
Hong Fei Sang
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Jun Jie Yuan
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Zhong Ming Qiu
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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  • ORCID record for Zhong Ming Qiu
Min Zhang
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Xiao Gang Hu
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Wen Hua Liu
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Ning Wang
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Hong Xing Han
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Tie Yu Tang
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Guo Yong Zeng
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Hui Dong
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Xing Min Long
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Ling Fei Li
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Feng Li Li
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Shuai Liu
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Wei Dong Luo
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Jia Cheng Huang
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Jia Xing Song
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Lin Yu Li
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Lu Ming Chen
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Dong Jing Xie
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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De Ping Wu
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Fang Fei Li
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Wen Jie Zi
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Qing Wu Yang
From the Department of Neurology (H.F.S., L.F.L.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Neurology (H.F.S., J.J.Y., Z.M.Q., X.M.L., F.L.L., S.L., W.D.L., J.C.H., J.X.S., L.Y.L., L.M.C., D.J.X., D.P.W., F.F.L., W.J.Z., Q.W.Y.), Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; Departments of Neurology (Z.M.Q.) and Cadre Health Care (H.D.), the 903rd Hospital of the People's Liberation Army, Hangzhou; Department of Neurology (M.Z.), Jiangmen Central Hospital; Department of Military Patient Management (X.G.H.), the 904th Hospital of the People's Liberation Army, Wuxi; Department of Neurology (W.H.L.), Wuhan No. 1 Hospital; Department of Neurology (N.W.), Nanyang Central Hospital; Department of Neurology (H.X.H.), Linyi People's Hospital; Department of Neurology (T.Y.T.), the Affiliated Hospital of Yangzhou University; Department of Neurology (G.Y.Z.), Ganzhou People's Hospital, China.
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Association Between Time to Endovascular Therapy and Outcomes in Patients With Acute Basilar Artery Occlusion
Hong Fei Sang, Jun Jie Yuan, Zhong Ming Qiu, Min Zhang, Xiao Gang Hu, Wen Hua Liu, Ning Wang, Hong Xing Han, Tie Yu Tang, Guo Yong Zeng, Hui Dong, Xing Min Long, Ling Fei Li, Feng Li Li, Shuai Liu, Wei Dong Luo, Jia Cheng Huang, Jia Xing Song, Lin Yu Li, Lu Ming Chen, Dong Jing Xie, De Ping Wu, Fang Fei Li, Wen Jie Zi, Qing Wu Yang
Neurology Nov 2021, 97 (22) e2152-e2163; DOI: 10.1212/WNL.0000000000012858

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Abstract

Objective To characterize the association of onset to puncture time (OPT) with clinical outcomes among patients with acute basilar artery occlusion receiving endovascular therapy (EVT) in clinical practice.

Methods Using the EVT for Acute Basilar Artery Occlusion (BASILAR) study, we identified consecutive patients with acute basilar artery occlusion receiving EVT in 47 comprehensive stroke centers in China from January 2014 to May 2019. The primary outcome was favorable functional outcome (defined as modified Rankin Scale score [mRS] 0–3) at 90 days. Secondary outcomes included function independence (mRS 0–2), mortality, and symptomatic intracerebral hemorrhage. The associations of OPT with clinical outcomes were analyzed using multivariable logistic regression (OPT as a categorical variable) and restricted cubic spline regression (OPT as a continuous variable).

Results Among 639 eligible patients, the median age was 64 years, and median OPT was 328 minutes (interquartile range 220–490). Treatment within 4–8 hours and 8–12 hours was associated with lower rates of favorable outcome (adjusted odds ratio, 0.63 [95% confidence interval (CI), 0.40–0.98] and 0.47 [95% CI, 0.23–0.93], respectively) compared with treatment within 4 hours. Restricted cubic spline regression analysis showed that the OPT had L-shaped associations with favorable outcome (pnonlinearity = 0.028) and functional independence (pnonlinearity = 0.025), with significant benefit loss throughout the first 9 hours, but then appeared relatively flat. The odds of mortality increased relatively for OPT up to 9 hours, but then leveled off (pnonlinearity = 0.042). The association between symptomatic intracerebral hemorrhage and OPT was not significant.

Conclusion Among patients with acute basilar artery occlusion in routine practice, earlier treatment with EVT was associated with better outcomes throughout the first 9 hours after onset, but benefit may sustain unchanged afterwards.

Classification of Evidence This study provides Class II evidence that for patients with acute ischemic stroke due to basilar artery occlusion, earlier EVT is associated with better outcomes.

Glossary

ASITN/SIR=
American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology;
BA=
basilar artery;
BAO=
basilar artery occlusion;
CI=
confidence interval;
EVT=
endovascular therapy;
IQR=
interquartile range;
mRS=
modified Rankin Scale;
NIHSS=
NIH Stroke Scale;
OPT=
onset-to-puncture time;
OR=
odds ratio;
pc-ASPECTS=
posterior circulation Acute Stroke Prognosis Early CT Score;
sICH=
symptomatic intracerebral hemorrhage

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • ↵* These authors contributed equally as co–first authors.

  • ↵† Wen Jie Zi and Qing Wu Yang contributed equally as co–senior authors.

  • Class of Evidence: NPub.org/coe

  • See page e2250

  • Received January 21, 2021.
  • Accepted in final form August 30, 2021.
  • © 2021 American Academy of Neurology
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