21. Kết quả điều trị tái tưới máu bệnh nhân nhồi máu não cấp do tắc động mạch thân nền

Abstract

Current guidelines of American Hypertension Association/American Stroke Association (AHA/ASA) and European Stroke Organization (ESO) focus mainly on reperfusion therapy in acute ischemic stroke of anterior circulation, without specific recommendations for endovascular therapy in acute ischemic stroke due to basilar artery occlusion. There is one controversy question that: whether endovascular therapy can be really effective and safe in treatment of acute ischemic stroke due to basilar artery occlusion. In Vietnam, there are few published studies on the efficacy and safety of reperfusion therapy of acute ischemic stroke due to basilar artery occlusion. Objectives: evaluate the results of reperfusion therapy for patients with acute ischemic stroke due to basilar artery occlusion at the Stroke Center of Bach Mai Hospital. Methods: Prospective, descriptive study on 41 patients with acute ischemic stroke due to basilar artery occlusion within 24 hours from onset who were admitted at the Stroke Center of Bach Mai Hospital, the stuthe dy was lauched in period of six months (from December 2021 to the end of May 2022). Results: There were 26/41 patients in the endovascular intervention group and 15/41 patients in the optimal medical treatment group. About the improved functional outcome (mRS day 90 from 0 - 3): there was no difference between the two groups (19.2% and 0%, p = 0.07). There was no difference in the 90th day mortality between the two groups (53.8 and 66.7%, p = 0.422). The percentage of symptomatic bleeding transformation in the endovascular intervention group was higher than in the optimal medical treatment group (p = 0.018). Conclusion: The benefit of endovascular therapy in acute ischemic stroke due to occlusion of the basilar artery has not been excluded.