About this Research Topic
Stroke is the leading cause of disability and death worldwide. Acute ischemic stroke (AIS) with large vessel occlusion (LVO) is associated with a very poor prognosis. Indeed, fatality rates in patients with no recanalized acute basilar artery occlusion (BAO) are up to 90%. Fortunately, reperfusion therapy including intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT) has emerged as a promising way to limit post-stroke disability in AIS patients with anterior circulation LVO and has potential in those with posterior circulation LVO.
According to recent trials (BASICS, BEST, ATTENTION, and BAOCHE), EVT appears to be effective in patients with BAO who have moderate-to-severe neurologic deficits and have limited early ischemic changes up to 24 hours after stroke onset. Unfortunately, there are still many unanswered questions about the treatment for posterior circulation stroke. For example, we don’t know the exact treatment window for IVT in AIS patients with BAO or other types of posterior circulation stroke, nor the efficacy of the combination of IVT followed by EVT. The application of multimodal imaging should be also investigated, such as mismatch profile (core and penumbra), collateral circulation, stroke severity evaluation, hemorrhagic transformation prediction, and so on. In addition, new EVT devices, optimal EVT strategies, and the use of neuroprotective agents should be investigated to reduce futile recanalization in patients with BAO.
This Research Topic aims to spotlight the latest findings and raise discussion about the optimization of IVT and EVT protocols, possible adjuvant therapies, and patient selection for the treatment of BAO.
We welcome the submission of any type of manuscript supported by the journal (including Original Research, Meta-Analysis, Review, etc.) about the treatment of the acute stage of posterior circulation LVO ischemic stroke. Potential themes relevant to this collection may include but are not limited to the following listed below:
- Selection of BAO patients for EVT. Is the benefit of EVT mainly confined to patients with intracranial atherosclerosis?
- What trials are needed going forward for EVT in BAO patients
- Thrombolytic therapy for posterior circulation stroke patients with or without LVO. Focus on the treatment of BAOs is especially welcome
- Advanced imaging technique for patient selection for reperfusion therapy in posterior circulation stroke patients
- Treatment window for IVT in AIS patients with BAO or other types of posterior circulation stroke
- Medical treatment for neuroprotection in posterior circulation stroke patients
Dr. Nguyen reports research support from Medtronic and the Society of Vascular and Interventional Neurology (both paid to the institution). The other Topic Editors declare no competing interests with regard to the Research Topic subject.
According to recent trials (BASICS, BEST, ATTENTION, and BAOCHE), EVT appears to be effective in patients with BAO who have moderate-to-severe neurologic deficits and have limited early ischemic changes up to 24 hours after stroke onset. Unfortunately, there are still many unanswered questions about the treatment for posterior circulation stroke. For example, we don’t know the exact treatment window for IVT in AIS patients with BAO or other types of posterior circulation stroke, nor the efficacy of the combination of IVT followed by EVT. The application of multimodal imaging should be also investigated, such as mismatch profile (core and penumbra), collateral circulation, stroke severity evaluation, hemorrhagic transformation prediction, and so on. In addition, new EVT devices, optimal EVT strategies, and the use of neuroprotective agents should be investigated to reduce futile recanalization in patients with BAO.
This Research Topic aims to spotlight the latest findings and raise discussion about the optimization of IVT and EVT protocols, possible adjuvant therapies, and patient selection for the treatment of BAO.
We welcome the submission of any type of manuscript supported by the journal (including Original Research, Meta-Analysis, Review, etc.) about the treatment of the acute stage of posterior circulation LVO ischemic stroke. Potential themes relevant to this collection may include but are not limited to the following listed below:
- Selection of BAO patients for EVT. Is the benefit of EVT mainly confined to patients with intracranial atherosclerosis?
- What trials are needed going forward for EVT in BAO patients
- Thrombolytic therapy for posterior circulation stroke patients with or without LVO. Focus on the treatment of BAOs is especially welcome
- Advanced imaging technique for patient selection for reperfusion therapy in posterior circulation stroke patients
- Treatment window for IVT in AIS patients with BAO or other types of posterior circulation stroke
- Medical treatment for neuroprotection in posterior circulation stroke patients
Dr. Nguyen reports research support from Medtronic and the Society of Vascular and Interventional Neurology (both paid to the institution). The other Topic Editors declare no competing interests with regard to the Research Topic subject.
Keywords: Medical treatment, posterior circulation stroke, basilar artery occlusion, endovascular thrombectomy, imaging, thrombolysis
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