{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:52:58Z","timestamp":1791355978908,"version":"4.3.1"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,10,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Endovascular treatment (EVT) is the standard of care for acute basilar artery occlusion (BAO) although the role of bridging intravenous thrombolysis (IVT) with alteplase prior to EVT remains debated. Whether the effect of bridging IVT differs across EVT techniques has not been systematically assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We conducted a retrospective multicenter analysis including consecutive patients with BAO treated with EVT at 7 comprehensive stroke centers between 2019 and 2023. Patients were stratified according to first\u2010line thrombectomy technique: direct thromboaspiration (BAO\n                      <jats:sub>TA<\/jats:sub>\n                      ), stent retriever (BAO\n                      <jats:sub>ST<\/jats:sub>\n                      ), or combined approach (BAO\n                      <jats:sub>CO<\/jats:sub>\n                      ). Outcomes were analyzed using inverse probability weighting to adjust for baseline imbalances. The primary end point was 90\u2010day favorable functional outcome (modified Rankin Scale 0\u20133) and ordinal 90\u2010day modified Rankin Scale shift. Secondary end points included 90\u2010day functional independence (modified Rankin Scale 0\u20132), successful reperfusion, 90\u2010day mortality, hemorrhagic transformation, and symptomatic intracerebral hemorrhage. Sensitivity analyses with trimmed weights and subgroup analyses were prespecified.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      A total of 517 patients were included: 200 BAO\n                      <jats:sub>TA<\/jats:sub>\n                      , 260 BAO\n                      <jats:sub>ST,<\/jats:sub>\n                      and 57 BAO\n                      <jats:sub>CO<\/jats:sub>\n                      . In patients with BAO\n                      <jats:sub>TA<\/jats:sub>\n                      , bridging IVT was associated with higher rates of 90\u2010day favorable outcome (risk ratio [RR] 1.47, 95% CI 1.00\u20132.16) and improved 90\u2010day modified Rankin Scale shift. In patients with BAO\n                      <jats:sub>ST<\/jats:sub>\n                      bridging IVT significantly reduced symptomatic intracerebral hemorrhage risk (RR 0.27, 95% CI 0.09\u20130.77) while in patients with BAO\n                      <jats:sub>CO<\/jats:sub>\n                      functional independence was numerically more frequent among patients treated with bridging IVT (RR 1.91, 95% CI 1.08\u20133.37).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Bridging IVT was associated with differences in clinical and safety outcomes across EVT strategies. However, no statistically significant interaction was observed between treatment allocation and EVT technique. Therefore, these findings should be interpreted as descriptive and hypothesis\u2010generating rather than evidence of true differences in treatment effect.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.047678","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T13:27:40Z","timestamp":1789738060000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Role of Thrombectomy Technique in Alteplase Bridging Intravenous Thrombolysis for Basilar Artery Occlusion"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1676-2897","authenticated-orcid":false,"given":"Muhammad","family":"Jaffar","sequence":"first","affiliation":[{"name":"Charing Cross Hospital, Imperial College London NHS Healthcare Trust","place":["London, 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