{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T10:09:00Z","timestamp":1791886140769,"version":"4.3.4"},"reference-count":36,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Interv Neuroradiol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Endovascular therapy (EVT) improves functional outcomes and reduces mortality in acute ischemic stroke (AIS) due to basilar artery occlusion (BAO). However, data on hemorrhagic complications and nonneurologic adverse events remain limited. We conducted a systematic review and meta-analysis to assess these outcomes in randomized controlled trials (RCTs) comparing EVT versus best medical management (BMM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed, Cochrane Library, and Embase in December 2024 for RCTs comparing EVT and BMM (PROSPERO registry CRD42024617681). Outcomes included any parenchymal hematoma (PH), PH type 1 and 2, subarachnoid hemorrhage (SAH), systemic\/extracranial hemorrhage, pneumonia, and heart failure. Pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated using a random-effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four RCTs, 988 patients (556 EVT, 432 BMM), were included. EVT increased the risk of SAH (RR 5.14; 95% CI [1.35\u201319.56]; I\u00b2\u2009=\u20090.0%) and PH type 2 (RR 5.53; 95% CI [1.47\u201320.84]; I\u00b2\u2009=\u20090.0%) compared to BMM. No significant differences were observed for any PH (RR 1.91; 95% CI [0.92\u20133.97]; I\u00b2\u2009=\u20090.0%), PH type 1 (RR 0.71; 95% CI [0.22\u20132.29]; I\u00b2\u2009=\u20093.4%), systemic\/extracranial hemorrhage (RR 1.06; 95% CI [0.71\u20131.60]; I\u00b2\u2009=\u200912.2%), pneumonia (RR 1.00; 95% CI [0.83\u20131.21]; I\u00b2\u2009=\u20090.0%), or heart failure (RR 2.00; 95% CI [0.34\u201311.92]; I\u00b2\u2009=\u200955.4%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with BAO AIS, EVT is associated with an increased risk of SAH and PH type 2 compared with BMM. There was no significant difference in any PH, PH type 1, systemic\/extracranial hemorrhage, pneumonia, and heart failure between groups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15910199251383070","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T19:41:38Z","timestamp":1759261298000},"page":"2764-2771","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Safety outcomes in endovascular treatment versus best medical management for basilar artery occlusion acute ischemic stroke: A systematic review and meta-analysis of randomized trials"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6750-8170","authenticated-orcid":false,"given":"Jo\u00e3o Victor","family":"Sanders","sequence":"first","affiliation":[{"name":"Advocate Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9019-0130","authenticated-orcid":false,"given":"Luma Maria","family":"Tavares de Sousa","sequence":"additional","affiliation":[{"name":"Universidade Federal do Cear\u00e1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6103-8420","authenticated-orcid":false,"given":"Oc\u00edlio","family":"de Deus","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidade Federal do Piau\u00ed, Teresina, Piau\u00ed, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1801-9055","authenticated-orcid":false,"given":"Marion","family":"Oliver","sequence":"additional","affiliation":[{"name":"Advocate Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4532-153X","authenticated-orcid":false,"given":"Raul G","family":"Nogueira","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6280-0113","authenticated-orcid":false,"given":"Demetrius","family":"Lopes","sequence":"additional","affiliation":[{"name":"Advocate Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3564-6958","authenticated-orcid":false,"given":"Krishna","family":"Joshi","sequence":"additional","affiliation":[{"name":"Advocate Health"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(11)70229-0"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.8.3.383"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-199307000-00012"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002129"},{"key":"e_1_3_2_6_2","first-page":"545","article-title":"Occlusion of the basilar artery: a review with 17 personal cases (author\u2019s transl)","volume":"137","author":"Labauge R","year":"1981","unstructured":"Labauge R, Pages M, Marty-Double C, et al. Occlusion of the basilar artery: a review with 17 personal cases (author\u2019s transl). Rev Neurol 1981; 137: 545\u2013571.","journal-title":"Rev Neurol"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14628"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1411587"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1414905"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1414792"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1503780"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1415061"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1706442"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1713973"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2118191"},{"key":"e_1_3_2_16_2","first-page":"401","article-title":"Local intraarterial thrombolysis in vertebrobasilar thromboembolic disease","volume":"4","author":"Zeumer H","year":"1983","unstructured":"Zeumer H, Hacke W, Ringelstein EB. Local intraarterial thrombolysis in vertebrobasilar thromboembolic disease. AJNR Am J Neuroradiol 1983; 4: 401\u2013404.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70173-5"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(19)30395-3"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2206317"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2207576"},{"key":"e_1_3_2_21_2","first-page":"01820","article-title":"Endovascular therapy for acute vertebrobasilar occlusion (VERITAS): a systematic review and individual patient data meta-analysis","volume":"0140","author":"Nogueira RG","year":"2024","unstructured":"Nogueira RG, Jovin TG, Liu X, et al. Endovascular therapy for acute vertebrobasilar occlusion (VERITAS): a systematic review and individual patient data meta-analysis. Lancet 2024; S0140-6736: 01820\u20138. Epub ahead of print. PMID: 39674187.","journal-title":"Lancet"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.663058"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-024-03424-w"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A7594"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/15910199231163046"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-020-01653-z"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics14171856"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2023.107217"},{"key":"e_1_3_2_29_2","article-title":"Predictors of parenchymal hematoma and clinical outcome after mechanical thrombectomy in patients with large ischemic core due to large vessel occlusion: a retrospective multicenter study","volume":"17","author":"Alexandre AM","year":"2023","unstructured":"Alexandre AM, Scarcia L, Brunetti V, et al. Predictors of parenchymal hematoma and clinical outcome after mechanical thrombectomy in patients with large ischemic core due to large vessel occlusion: a retrospective multicenter study. J Neuro Interventional Surgery 2023; 17: e87\u2013e95.","journal-title":"J Neuro Interventional Surgery"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.015648"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2018-014380"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.500868"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.119.025914"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2022.106507"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.024255"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnis-2023-021219"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000213509"}],"container-title":["Interventional Neuroradiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15910199251383070","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15910199251383070","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15910199251383070","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:35:55Z","timestamp":1790692555000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15910199251383070"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,30]]},"references-count":36,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1177\/15910199251383070"],"URL":"https:\/\/doi.org\/10.1177\/15910199251383070","relation":{},"ISSN":["1591-0199","2385-2011"],"issn-type":[{"value":"1591-0199","type":"print"},{"value":"2385-2011","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,30]]}}}