Publication details

Perceptions on basilar artery occlusion management in China versus other countries: Analysis of the after the BEST of BASICS (ABBA) survey

Authors	HUO Xiaochuan KLEIN Piers RAYNALD Drumm Brian CHEN Yimin QURESHI Muhammad M SCHONEWILLE Wouter J LIU Xinfeng HU Wei JI Xunming LI Chuanhui ZHU Yuyou ABDALKADER Mohamad STRBIAN Daniel FISCHER Urs PUETZ Volker ALEMSEGED Fana YAMAGAMI Hiroshi SACCO Simona SAPOSNIK Gustavo MICHEL Patrik KRISTOFFERSEN Espen Saxhaug ŠEDOVÁ Petra MIKULÍK Robert SIEGLER James E LOBOTESIS Kyriakos ROI Dylan DEMEESTERE Jelle HAN Hongxin YUAN Guangxiong TON Mai Duy CHEN Hui-Sheng YANG Qingwu QIU Zhongming MARTINS Sheila O. TSIVGOULIS Georgios THOMALLA Gotz NAGEL Simon CAMPBELL Bruce C. V. JOVIN Tudor G. NOGUEIRA Raul G. RAYMOND Jean BANERJEE Soma NGUYEN Thanh N. MIAO Zhongrong
Year of publication	2022
Type	Article in Periodical
Magazine / Source	Journal of Stroke and Cerebrovascular Diseases
MU Faculty or unit	Faculty of Medicine
Citation
web	https://www.sciencedirect.com/science/article/pii/S1052305722004980?via%3Dihub
Doi	http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2022.106804
Keywords	Basilar artery occlusion; Mechanical thrombectomy; Endovascular therapy; Intravenous thrombolysis
Description	Introduction Uncertainty remains on the optimal management of basilar artery occlusion (BAO). Two large randomized controlled trials (RCTs) in 2019 and 2021 demonstrated neutral results with respect to the use of endovascular therapy (EVT) for BAO. This study aimed to understand regional variation in physicians' perceptions towards the treatment of BAO as stratified by physician respondents from China versus outside China, prior to the publication of studies demonstrating a benefit of EVT for BAO. Methods An international online survey was conducted of stroke neurologists and neurointerventionalists from January to March 2022. Survey questions evaluated physician opinions toward the use of EVT in BAO, as well as the clinical and imaging features underlying treatment decisions. Respondents were dichotomized as either from China or from other countries and differences between groups were analyzed. Results There were 1245 physician respondents across 73 countries of which 295 (23.7%) were from China. Compared to respondents from the rest of the world, respondents from China were more likely to be interventionalists (71.5% vs 35.0%; p < 0.0001). Overall, more than 95% of respondents believed that EVT was superior to medical therapy under certain circumstances. Chinese respondents were more likely to believe that further RCTs were necessary than respondents from other countries (93.6% vs 76.2%; p < 0.0001). Chinese respondents were more likely to use advanced imaging in later time windows and use a premorbid mRS threshold of ?2 for BAO selection to EVT. Conclusion Most stroke physicians believe EVT is beneficial in selected patients with BAO. Clinical and imaging modality differences were observed in the selection criteria used for EVT. There was greater inclination to enroll all trial eligible patients in a BAO RCT by respondents from China as compared to other parts of the world.