Endovascular treatment for non-acute intracranial vertebrobasilar artery occlusion in Chinese elderly: Efficacy and safety outcomes.

BACKGROUND

There is a lack of effective treatments for non-acute intracranial vertebrobasilar artery occlusion (NAIVBAO). Despite aggressive medical treatment, recurrent ischemic stroke or transient ischemic attack related to the occluded artery continues to occur repeatedly. This study aims to investigate the efficacy and safety of endovascular recanalization for NAIVBAO in Chinese Elderly.

METHODS

Patients with NAIVBAO who underwent endovascular treatment (EVT) from 2016 to 2022 and had symptom onset more than 24 h were included. Patients receiving conservative drug treatment were selected as the control group. The primary outcome was stroke recurrence or death during one-year of follow-up.

RESULTS

A total of 150 eligible patients were selected from 476 cases of non-acute occlusion. Among them, 122 were male (81%) and 28 were female (19%). Compared to the conservative treatment group, the EVT group had significantly lower rates of stroke recurrence or death during follow-up (10% vs. 30%, adjusted odds ratio [aOR]: 8.7, 95% CI: 2.0-37.4; P = 0.004). The proportion of patients with mRS scores of 0-3 was significantly higher in the EVT group (80% vs. 60%; aOR: 5.6, 95% CI: 1.3-23.4; P = 0.019) compared with the conservative treatment group. Multivariate regression analysis revealed that EVT was superior to conservative medical treatment (aOR: 6.01, 95%CI: 1.21-29.77, P = 0.030) during one-year follow-up.

CONCLUSIONS

EVT is safe and feasible for elderly Chinese patients with NAIVBAO, reducing the risk of stroke recurrence or death and significantly improving one-year clinical outcomes. Given the study's single-center retrospective design and limited sample size, future large-scale, multicenter randomized controlled trials are required to validate these findings.