Endovascular revascularization of vertebrobasilar tandem occlusions in comparison to isolated basilar artery occlusions: A multi-center experience.

Klail, Tomas; Piechowiak, Eike I; Krug, Nadja; Maegerlein, Christian; Maus, Volker; Fischer, Sebastian; Lobsien, Donald; Pielenz, Daniel; Styczen, Hanna; Deuschl, Cornelius; Thormann, Maximilian; Diamandis, Elie; Heldner, Mirjam R; Kaesmacher, Johannes; Mordasini, Pasquale (2024). Endovascular revascularization of vertebrobasilar tandem occlusions in comparison to isolated basilar artery occlusions: A multi-center experience. (In Press). Interventional neuroradiology(15910199241240045), p. 15910199241240045. Sage Publications 10.1177/15910199241240045

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Acute basilar artery occlusion (BAO) is a severe disease that is associated with an 85% mortality rate if untreated. Several studies have analyzed the use of mechanical thrombectomy (MT) in the different scenarios of BAO. However, the results remain conflicting and the role of MT as standard of care for vertebrobasilar tandem occlusions (VBTO) has not been confirmed. Our goal was to assess technical feasibility, safety, and functional outcome of endovascular treatment of VBTO in comparison to isolated BAO (IBAO).


We retrospectively reviewed all prospectively collected patients with acute BAO from six tertiary centers between September 2016 and November 2021. Patients were subsequently divided into two groups: VBTO and IBAO. Baseline data, procedural details, and outcomes were compared between groups.


A total of 190 patients were included, 55 presenting with a VBTO and 135 with IBAO. Successful recanalization was equally common in both groups (89.1% and 86.0%). Rates of favorable functional outcome (modified Rankin Scale: 0-2) were higher in patients with VBTO compared to IBAO (36.4% vs. 25.2%, p = 0.048) and mortality was lower (29.1% vs. 33.3%). However, these associations faded after adjustment for confounders (adjusted odds ratio [aOR] 0.86, 95% CI 0.35-2.05; aOR 0.93, 95% CI 0.35-2.45). Rates of symptomatic intracranial hemorrhage did not differ between the groups (VBTO: 7.3% vs. IBAO: 4.2%; p = 0.496).


Endovascular treatment of VBTO is technically feasible and safe with similar rates of successful recanalization, favorable functional outcome, and mortality to those in patients with IBAO.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Klail, Tomas, Piechowiak, Eike Immo, Heldner, Mirjam Rachel, Kaesmacher, Johannes, Mordasini, Pasquale Ranato


600 Technology > 610 Medicine & health




Sage Publications




Pubmed Import

Date Deposited:

08 Apr 2024 11:22

Last Modified:

09 Apr 2024 00:17

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Tandem occlusions mechanical thrombectomy stroke vertebrobasilar



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