• Kristian Barlinn, Ulf Becker, Volker Puetz, Imanuel Dzialowski, Alexander Kunz, Jessica Kepplinger, Rüdiger von Kummer, and Georg Gahn.
• Department of Neurology, Dresden University Stroke Center, University of Technology Dresden, Dresden, Germany. Barlinn@uniklinikum-dresden.de
• J Neuroimaging. 2012 Apr 1;22(2):167-71.

BackgroundThe best therapeutic approach in patients with acute basilar artery occlusion (BAO) remains unclear. We report the results of a combined treatment approach with intravenous (IV) abciximab and intraarterial (IA) tissue plasminogen activator (tPA) in these patients.MethodsWe prospectively studied patients with acute BAO on CT-angiography or MR-angiography. We treated patients with IV abciximab followed by IA thrombolysis with tPA. Primary outcome was partial or complete recanalization according to thrombolysis in myocardial infarction 2 to 3 flow grades on catheter angiography. Secondary outcomes were favorable functional outcome (mRS score ≤3) and mortality at 90 days.ResultsOf 20 patients, mean age was 62 ± 13 years, median baseline National Institutes of Health Stroke Scale (NIHSS) score 25.5 (IQR 12-28), and median Glasgow Coma Scale score 7 (IQR 6-11). Mean time to IA treatment was 7 ± 2.8 hours. We achieved partial or complete recanalization in 17/20 patients (85%). At 3 months, 3/20 patients (15%) had a favorable functional outcome and 9/20 patients (45%) were deceased.ConclusionsCombined treatment with IV abciximab and IA tPA yielded a high recanalization rate in patients with BAO. However, functional outcomes were poor, potentially due to late initiation of treatment. Early treatment might improve functional outcome.Copyright © 2011 by the American Society of Neuroimaging.

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