Abstract TP025: Impact of Extracranial Vertebral Artery Occlusion on Outcomes of Basilar Artery Occlusion Patients Undergoing Mechanical Thrombectomy

Background and Objective: Extracranial vertebral artery occlusion may be seen concurrently in acute ischemic stroke patients with acute basilar artery occlusion. We determined the frequency and associated outcomes of concurrent extracranial vertebral artery occlusion in patients with acute basilar artery occlusion who underwent thrombectomy. Methods: We analyzed data from a prospective stroke registry at a comprehensive stroke center between January 2019 and April 2025. We identified all acute ischemic stroke patients who had basilar artery occlusion and compared the demographic and clinical characteristics, procedural times, and outcomes at discharge in patients with and without concurrent extracranial vertebral artery occlusion. Results: Among acute ischemic stroke patients with basilar artery occlusion, concurrent extracranial vertebral artery occlusion was observed in (46.4%) patients. The proportion of patients with a National institutes of health stroke scale (NIHSS) score < 10 at discharge was lower in patients with extracranial vertebral artery occlusion compared with those without extracranial vertebral artery occlusion (11.5% versus 33.3%, p=0.0540). The time interval between groin puncture to reperfusion was significantly longer in the patients with extracranial vertebral artery occlusion (48.9 minutes versus 32.2 minutes, p = 0.0136). Recanalization rates were similar between patients with and without extracranial vertebral artery occlusion (92.3% versus 96.7%, p=0.4700). The odds of in-hospital mortality were significantly higher among patients with extracranial vertebral artery occlusion (odds ratio 5.37, p=0.0253) after adjusting for age, gender, admission NIHSS score, and intravenous thrombolytic use. Conclusions: Acute ischemic stroke patients with basilar artery occlusion who have concurrent extracranial vertebral artery occlusion have longer procedure time and higher in-hospital mortality after undergoing thrombectomy.