AUTHOR=Zhao Chenhao , Luo Weidong , Liu Xing , Luo Jun , Song Jiaxing , Yuan Junjie , Liu Shuai , Huang Jiacheng , Kong Weilin , Hu Jinrong , Yang Jie , Sun Ruidi , Yue Chengsong , Xie Dongjing , Li Linyu , Sang Hongfei , Qiu Zhongming , Li Fengli , Wu Deping , Zi Wenjie , Yang Qingwu 

TITLE=Effect of atrial fibrillation on outcomes after mechanical thrombectomy and long-term ischemic recurrence in patients with acute basilar artery occlusion

JOURNAL=Frontiers in Neurology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.909677

DOI=10.3389/fneur.2022.909677

ISSN=1664-2295

ABSTRACT=IIntroduction
45 According to literature on anterior circulation, comorbid atrial fibrillation (AF) is not 
46 associated with a worse functional outcome, lower reperfusion rates, or higher rates of 
47 intracranial hemorrhage after mechanical thrombectomy (MT) compared to intravenous 
48 thrombolysis (IVT) or treatment with supportive care. However, data are limited for the 
49 effect of comorbid AF on procedural and clinical outcomes of acute basilar artery 
50 occlusion (ABAO) after MT. This study aimed to investigate the effect of atrial 
51 fibrillation on outcomes after MT and long-term ischemic recurrence in patients with 
52 ABAO.
53 Methods 
54 We performed a register study of the Endovascular Treatment for Acute Basilar Artery 
55 Occlusion Study (BASILAR, which is registered on the Chinese
56 Clinical Trial Registry，http://www.chictr.org.cn;ChiCTR1800014759) from January 
57 2014 to May 2019 and included 647 patients who underwent MT for ABAO, 136 of 
58 whom had comorbid AF. Prospectively defined baseline characteristics, procedural 
59 outcomes, and clinical outcomes were reported and compared.
60 Results 
61 On multivariate analysis, AF predicted a shorter puncture-to-recanalization time, higher 
62 first-pass effect rate, and lower incidence of angioplasty and/or stenting (p<0.01). AF 
63 had no effect on intracranial hemorrhage incidence (adjusted odds ratio [aOR], 1.093; 
64 95% confidence interval [CI], 0.451–2.652), 90-day functional outcomes (adjusted 
65 common odds ratio, 0.915; 95% CI, 0.588–1.424), or mortality (aOR, 0.851; 95% CI, 
66 0.491–1.475) after MT. The main findings were robust in the subgroup and 1-year 
67 follow-up analyses. Comorbid AF was the remaining predictor of ischemic recurrence 
68 (aOR, 4.076; 95% CI, 1.137–14.612).
69 Conclusions 
70 The study revealed no significant difference in the safety and efficacy of MT for ABAO 
71 regardless of whether patients had comorbid AF. However, a higher proportion of 
72 patients with AF experienced ischemic recurrence within 1 year after MT.