Outcomes of Endovascular Treatment for Acute Basilar Artery Occlusion With National Institutes of Health Stroke Scale Score ≤10

BACKGROUND: The effectiveness and safety of endovascular treatment (EVT) compared with standard medical treatment (SMT) for acute basilar artery occlusion in patients with National Institutes of Health Stroke Scale (NIHSS) scores ≤10 remain unclear. This study aimed to investigate the effectiveness and safety of EVT versus SMT in patients with acute basilar artery occlusion with NIHSS scores ≤10. METHODS: Patients with acute basilar artery occlusion and NIHSS scores ≤10 included in this study were derived from a nationwide prospective registry in China. Patients were divided into the EVT and SMT groups. The primary outcome was the distribution of modified Rankin Scale score at 90 days. Safety outcomes included death at 90 days and symptomatic intracerebral hemorrhage within 48 hours. RESULTS: Among 106 patients, 78 (73.6%) received EVT. The median age was 64 (interquartile range, 59-71) years, and 23 (21.7%) were women. Compared with SMT, EVT was associated with a favorable shift in the distribution of modified Rankin Scale score at 90 days (adjusted odds ratio, 6.22 [95% CI, 2.31-16.73]) and lower 90-day death (adjusted odds ratio, 0.23 [95% CI, 0.06-0.88]). There was no significant difference in the incidence of symptomatic intracerebral hemorrhage within 48 hours between the 2 groups. At 1-year follow-up, functional outcomes continued to favor EVT over SMT. In both groups, as the baseline NIHSS score increased, the probability of achieving favorable outcomes progressively decreased, while the probability of death increased. CONCLUSIONS: In patients with acute basilar artery occlusion and NIHSS scores of ≤10, EVT was associated with better functional outcomes and lower mortality rate.