{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:09:27Z","timestamp":1777943367077,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T00:00:00Z","timestamp":1749772800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T00:00:00Z","timestamp":1749772800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Helsinki University Hospital governmental subsidiary funds for clinical research"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Randomized controlled trials have demonstrated an improved outcome of basilar artery occlusion (BAO) with endovascular thrombectomy (EVT) compared to best medical treatment. However, a minority of the patients recruited up to 12\u201324 h from onset in the positive trials received intravenous thrombolysis (IVT), and a trial with a higher IVT rate did not show superiority of EVT. Thus, the efficacy and safety of EVT compared to IVT for BAO remain less clear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>We aimed to compare outcomes after IVT alone to EVT with or without IVT for acute BAO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This international, observational, retrospective study included patients who received recanalization therapy for BAO at six centers between January 2010 and March 2024. The primary outcome was 3-month modified Rankin Scale (mRS) score 0\u20133, and secondary outcomes comprised mRS 0\u20132, ordinal mRS, mortality, and symptomatic intracranial hemorrhage. Outcomes after IVT versus EVT\u2009\u00b1\u2009IVT were compared using inverse probability-weighted regression adjustment models adjusting for known predictors of outcome in BAO and baseline variables differing between the treatment groups. Interaction of the treatment group with symptom severity and onset-to-treatment time was tested.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 523 patients with BAO (median age 69, 35.2% women), 28.9% received IVT and 71.1% EVT\u2009\u00b1\u2009IVT. The IVT-alone group had a lower baseline National Institutes of Health Stroke Scale score (median 11 vs 15) but equally extensive ischemic changes in baseline imaging. After inverse probability-weighted regression adjustment, the IVT-alone group had higher odds of mRS 0\u20133 (adjusted odds ratio (aOR) = 2.33 [95% confidence interval (CI) = 1.31\u20134.12]), mRS 0\u20132 (aOR = 1.93 [95% CI = 1.12\u20133.30]), lower median mRS (aOR = 1.81 [95% CI = 1.21\u20132.71]), and lower mortality (aOR = 0.53 [95% CI = 0.29\u20130.97]), but no difference in symptomatic intracranial hemorrhage (aOR = 0.81 [95% CI = 0.28\u20132.36]). No interactions for the primary outcome were found.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In this study, patients with BAO had better outcome after IVT than EVT \u00b1 IVT independent of symptom severity and time from onset. Although the non-randomized design of the study warrants caution, the results encourage further trials comparing EVT and IVT to guide recanalization therapy in BAO patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data access statement:<\/jats:title>\n                    <jats:p>Anonymized data are available upon reasonable request to the corresponding author following the national legislation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17474930251344451","type":"journal-article","created":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T01:23:16Z","timestamp":1749864196000},"page":"1114-1122","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Intravenous thrombolysis versus endovascular thrombectomy in acute basilar artery occlusion\u2014A multicenter cohort study"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6921-0597","authenticated-orcid":false,"given":"Silja","family":"R\u00e4ty","sequence":"first","affiliation":[{"name":"Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4429-2714","authenticated-orcid":false,"given":"Davide","family":"Strambo","sequence":"additional","affiliation":[{"name":"Service of Neurology, Department of Clinical Neurosciences, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Gomez-Exposito","sequence":"additional","affiliation":[{"name":"Department of Neurology &amp; Stroke, University of T\u00fcbingen, T\u00fcbingen, Germany"},{"name":"Hertie Institute for Clinical Brain Research, University of T\u00fcbingen, T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2277-5950","authenticated-orcid":false,"given":"Jo\u00e3o Pedro","family":"Marto","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal"},{"name":"Lisbon Clinical Academic Center, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9678-3422","authenticated-orcid":false,"given":"Jo\u00e3o Nuno","family":"Ramos","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Krebs","sequence":"additional","affiliation":[{"name":"Department of Neurology, St John\u2019s Hospital Vienna, Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9547-4940","authenticated-orcid":false,"given":"Pekka","family":"Virtanen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juhani","family":"Ritvonen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad","family":"Abdalkader","sequence":"additional","affiliation":[{"name":"Departments of Neurology and Radiology, Boston Medical Center, Boston, MA, 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