ORIGINAL RESEARCH article
Front. Neurol.
Sec. Endovascular and Interventional Neurology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1634708
Impact of thrombolytic therapy on basilar artery occlusion patients with atrial fibrillation: results from a multi-center prospective cohort study
Provisionally accepted
- 1Department of Neurology, the First Affiliated Hospital (Yijishan Hospital) of Wannan Medical College, Wuhu City, Anhui Province, China
- 2Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui Province, China
- 3Institutes of Brain Science, Wannan Medical College, Wuhu, Anhui Province, China
- 4Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
The benefits and risks of intravenous thrombolysis combined with endovascular treatment for basilar artery occlusion patients with atrial fibrillation (AF) are uncertain. This research investigates the disparities in the impact of bridging thrombolysis on the long-term prognoses of endovascular treatment between patients with AF and those without it.We analyzed data from a Chinese multi-center prospective registry conducted between March 2017 and February 2023. Primary analysis included favorable (mRS 0-2) and good (mRS 0-3) outcomes at 3 months, the risk ratio (aOR) and 95% confidence interval for the outcome associated with bridging thrombolysis were calculated using multivariate regression analysis. Subgroup analyses evaluated the relative excess risk index (REPI) for AF and intravenous thrombolysis.Results: Among 1,368 patients, the ratio of AF to non-AF patients was 434:934, the proportion receiving intravenous thrombolysis was 101 vs. 226. In the AF group, thrombolysis improved functional prognosis (aOR 1.93, 95% CI 1.14 to 3.29, P = 0.01 for favorable; aOR 2.06, 95% CI 1.23 to 3.46, P = 0.006 for good outcomes), with no differences in the non-AF group.Cross-stratification analysis indicated that AF patients receiving thrombolysis had the highest rates of favorable (aOR 1.99, 95% CI 1.27 to 3.11, P = 0.002) and good outcomes (aOR 2.11, 95% CI 1.35 to 3.30, P = 0.001), suggesting a significant additive effect of the treatments (REPI 0.89, 95% CI: 0.07-1.71; P=0.02 and REPI 1.13, 95% CI: 0.24-2.02; P=0.004).The presence of AF modified the treatment effect of bridging thrombolysis in basilar artery occlusion. These findings warrant confirmation through RCT studies.
Keywords: Basilar Artery Occlusion (BAO), Atrial Fibrillation, intravenous thrombolysis, Endovascular thrombectomy, Bridging therapy
Received: 25 May 2025; Accepted: 26 Jun 2025.
Copyright: © 2025 Shang, Chu, Chen, Yang, Yang, Hu, Xu and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xianjin Shang, Department of Neurology, the First Affiliated Hospital (Yijishan Hospital) of Wannan Medical College, Wuhu City, Anhui Province, China
Zhiming Zhou, Department of Neurology, the First Affiliated Hospital (Yijishan Hospital) of Wannan Medical College, Wuhu City, Anhui Province, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.