Impact of cardioembolism versus large-artery atherosclerosis etiology on endovascular treatment for acute basilar artery occlusion: an analysis from the ATTENTION registry

OBJECTIVE: This study aimed to investigate whether stroke etiology (cardioembolism [CE] vs large-artery atherosclerosis [LAA]) influences the efficacy and clinical outcomes of endovascular treatment (EVT) in patients with acute basilar artery occlusion (BAO). METHODS: This study compared procedural characteristics, reperfusion success, and functional outcomes at discharge and at 90 days after stroke onset between patients with CE and LAA from the Endovascular Treatment for Acute Basilar Artery Occlusion (ATTENTION) registry. To assess the association between stroke etiology and clinical outcomes, ordinal multivariable logistic regression analyses were performed, adjusting for relevant baseline covariates. Adjusted odds ratios and 95% confidence intervals were reported. RESULTS: Among patients with acute BAO, there were no significant differences in procedural characteristics and successful reperfusion rates between the CE and LAA groups. Functional outcomes at discharge and 90 days after stroke were also comparable between the two groups. Multivariable analyses showed no independent association between stroke etiology and clinical outcomes. CONCLUSIONS: In patients with acute BAO, stroke etiology (CE vs LAA) was not independently associated with procedural success or functional outcomes. These findings suggest that EVT efficacy in BAO may be largely independent of underlying stroke mechanism.