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Title: Effect of Sex on Outcomes of Mechanical Thrombectomy in Basilar Artery Occlusion: A Multicenter Cohort Study
Authors: Tan, Benjamin Y.Q.
Siow, Isabel
Lee, Keng Siang
Chen, Vanessa
Ong, Natalie 
Gopinathan, Anil 
Yang, Cunli
Bhogal, Pervinder
Lam, Erika
Spooner, Oliver
Meyer, Lukas
Fiehler, Jens
Papanagiotou, Panagiotis
Kastrup, Andreas
Alexandrou, Maria
Zubel, Seraphine
Wu, Qingyu
Mpotsaris, Anastasios
Maus, Volker
Andersson, Tommy
Gontu, Vamsi
Arnberg, Fabian
Lee, Tsong-Hai
Chan, Bernard
Teoh, Hock Luen
Seet, Raymond C.S. 
Sharma, Vijay 
Yeo, Leonard L.L. 
Keywords: Sex
Acute ischaemic stroke
Basilar artery occlusion
Issue Date: 7-Apr-2022
Publisher: S. Karger AG
Citation: Tan, Benjamin Y.Q., Siow, Isabel, Lee, Keng Siang, Chen, Vanessa, Ong, Natalie, Gopinathan, Anil, Yang, Cunli, Bhogal, Pervinder, Lam, Erika, Spooner, Oliver, Meyer, Lukas, Fiehler, Jens, Papanagiotou, Panagiotis, Kastrup, Andreas, Alexandrou, Maria, Zubel, Seraphine, Wu, Qingyu, Mpotsaris, Anastasios, Maus, Volker, Andersson, Tommy, Gontu, Vamsi, Arnberg, Fabian, Lee, Tsong-Hai, Chan, Bernard, Teoh, Hock Luen, Seet, Raymond C.S., Sharma, Vijay, Yeo, Leonard L.L. (2022-04-07). Effect of Sex on Outcomes of Mechanical Thrombectomy in Basilar Artery Occlusion: A Multicenter Cohort Study. Cerebrovascular Diseases. ScholarBank@NUS Repository.
Rights: Attribution-NonCommercial 4.0 International
Abstract: Introduction: Identifying differences in outcome of basilar artery occlusion (BAO) between males and females may be useful in aiding clinical management. Recent studies have demonstrated widespread underrepresentation of women in acute stroke clinical trials. This international multicentre study aimed to determine sex differences in outcome after mechanical thrombectomy (MT) for patients with acute BAO. Methods: We performed a retrospective analysis of consecutive patients with BAO who had undergone MT in seven stroke centres across five countries (Singapore, Taiwan, United Kingdom, Sweden, and Germany), between 2015 and 2020. Primary outcome was a favourable functional outcome measured by a modified Ranking Scale (mRS) of 0–3 at 90 days. Secondary outcomes were mRS 0–3 upon discharge, mortality, symptomatic intracranial haemorrhage (sICH) and subarachnoid haemorrhage (SAH). Results: Among the 322 patients who underwent MT, 206 (64.0%) patients were male and 116 (36.0%) were female. Females were older than males (mean ± SD 70.9 ± 14.3 years vs. 65.6 ± 133.6 years; p = 0.001) and had higher rates of atrial fibrillation (38.9% vs. 24.2%; p = 0.012). Time from groin puncture to reperfusion was shorter in females than males (mean ± SD 57.2 ± 37.2 min vs. 71.1 ± 50.9 min; p = 0.021). Despite these differences, primary and secondary outcome measures were similar in females and males, with comparable rates of favourable 90-day mRS scores (mean ± SD 46 ± 39.7 vs. 71 ± 34.5; OR = 1.20; 95% confidence interval [CI] = 0.59–2.43; p = 0.611), favourable discharge mRS scores (mean ± SD 39 ± 31.6 vs. 43 ± 25.9; OR = 1.38; 95% CI = 0.69–2.78; p = 0.368) and in-hospital mortality (mean ± SD 30 ± 25.9 vs. 47 ± 22.8; OR = 1.15; 95% CI = 0.55–2.43; p = 0.710. Rates of complications such as sICH (mean ± SD 5 ± 4.3 vs. 9 ± 4.4; OR = 0.46; 95% CI = 0.08–2.66; p = 0.385) and SAH (mean ± SD 4 ± 3.4 vs. 5 ± 2.4; OR = 0.29; 95% CI = 0.03–3.09; p = 0.303) comparably low in both groups. Conclusion: Females achieved comparable functional outcomes compared with males after undergoing MT for BAO acute ischemic stroke.
Source Title: Cerebrovascular Diseases
ISSN: 1015-9770
DOI: 10.1159/000524048
Rights: Attribution-NonCommercial 4.0 International
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