Basilar artery occlusion management: An international survey of gender influence on management.

Peacock, Meabh; Drumm, Brian; Klein, Piers; Raymond, Jean; Huo, Xiaochuan; Chen, Yimin; Abdalkader, Mohamad; Schonewille, Wouter J; Liu, Xinfeng; Hu, Wei; Li, Chuanhui; Ji, Xunming; Alemseged, Fana; Liu, Liping; Siegler, James E; Nagel, Simon; Strbian, Daniel; Sacco, Simona; Yaghi, Shadi; Qureshi, Muhammad M; ... (2024). Basilar artery occlusion management: An international survey of gender influence on management. (In Press). Interventional neuroradiology, p. 15910199241265590. Sage 10.1177/15910199241265590

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BACKGROUND

The superiority of endovascular thrombectomy (EVT) over medical management was not established in two early basilar artery occlusion (BAO) randomized controlled trials. Despite this, many clinicians recommended EVT for acute BAO under certain circumstances. This paper aims to compare physicians' diagnostic and management strategies of BAO according to gender.

METHODS

From January to March 2022 an international survey was conducted regarding management strategies in acute BAO. We compared responses between clinicians by identifying gender. Questions were designed to examine clinical and imaging parameters influencing management of patients with BAO.

RESULTS

Among the 1245 respondents from 73 countries, 311 (25.0%) identified as female. This figure was 13.6% amongst interventionists. Geographically, female respondents were lowest in Asia (14.5%) and North America (23.9%). The proportion of respondents identifying as female was consistent regardless of their years of experience. Female respondents were more likely to choose time of onset as time of first estimated stroke like symptom (48.0% vs. 38.5%, p < .01), were less likely to favor thrombectomy in the V4 segment of vertebrobasilar artery occlusions (31.5% vs. 43.3%, p < .01), and were less likely to find it acceptable to enroll all patients who met trial criteria in the standard medical treatment arm of a clinical trial (41.2% vs. 47.0%, p = .01). Male respondents were more likely to agree that thrombolysis would not alter their decision on proceeding with EVT (93.7% vs. 88.3%, p < .01).

CONCLUSIONS

Female clinicians appear to be significantly underrepresented in stroke medicine. This is most pronounced amongst interventionists and in Asia. Although male and female opinions were closely aligned on many aspects of BAO management, differences in opinion were observed in a number of significant areas which influence decision making.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology 04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
UniBE Contributor:	Fischer, Urs Martin, Kaesmacher, Johannes
Subjects:	600 Technology > 610 Medicine & health
ISSN:	2385-2011
Publisher:	Sage
Language:	English
Submitter:	Pubmed Import
Date Deposited:	15 Aug 2024 08:29
Last Modified:	16 Aug 2024 00:16
Publisher DOI:	10.1177/15910199241265590
PubMed ID:	39140366
Uncontrolled Keywords:	Stroke basilar artery occlusion mechanical thrombectomy
URI:	https://boris.unibe.ch/id/eprint/199713