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December 4, 2025Open Access

Abstract 178: Endovascular versus medical management of basilar artery occlusion stroke with low NIH stroke scale

Key Points

Endovascular treatment was linked to increased mortality in low NIH stroke scale patients, suggesting a need for careful consideration.
Functional independence rates were similar between groups, with 33.8% in EVT and 34.0% in medical management, indicating no benefit from EVT.
Subgroup analysis revealed that EVT might benefit patients with embolic strokes and NIHSS above 5, with confidence intervals supporting these findings.
Propensity score matching was employed to adjust for variables, emphasizing the need for rigorous methodologies in clinical evaluations.

Abstract

Background The role of endovascular treatment (EVT) in basilar artery occlusion (BAO) stroke patients with low NIH Stroke Scale scores (NIHSS 5, EVT was associated with increased odds of functional independence (OR 1.88, 95% CI 1.10‐3.21, p=0.021) without increased mortality (OR 1.42, 95% CI 0.71‐2.86, p=0.32). For non‐embolic strokes, EVT did not improve discharge outcomes (OR 0.85, 95% CI 0.70‐1.03, p=0.17) and was linked to higher mortality (OR 3.84, 95% CI 2.49‐5.92, p5, but it may be harmful in non‐embolic cases, possibly driven by higher risks of respiratory complications associated with EVT. image

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