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10.07.2020 | Interventional Neuroradiology | Ausgabe 12/2020 Open Access

Neuroradiology 12/2020

Radiation exposure in endovascular stroke treatment of acute basilar artery occlusions—a matched-pair analysis

Neuroradiology > Ausgabe 12/2020
Charlotte S. Weyland, Arne Potreck, Ulf Neuberger, Markus A. Möhlenbruch, Simon Nagel, Peter A. Ringleb, Martin Bendszus, Johannes A. R. Pfaff
Wichtige Hinweise

Key Points

• There is a significant difference in radiation exposure of endovascular stroke treatment for basilar artery occlusions compared with middle cerebral artery occlusions.
• When reference levels for endovascular stroke treatment are discussed, separated recommendations for EST of the anterior and the posterior circulation appear reasonable.

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To determine the radiation exposure in endovascular stroke treatment (EST) of acute basilar artery occlusions (BAO) and compare it with radiation exposure of EST for embolic middle cerebral artery occlusions (MCAO).


In this retrospective analysis of an institutional review board−approved prospective stroke database of a comprehensive stroke center, we focused on radiation exposure (as per dose area product in Gy × cm2, median (IQR)), procedure time, and fluoroscopy time (in minutes, median [IQR]) in patients receiving EST for BAO. Patients who received EST for BAO were matched case by case with patients who received EST for MCAO according to number of thrombectomy attempts, target vessel reperfusion result, and thrombectomy technique.


Overall 180 patients (n = 90 in each group) were included in this analysis. General anesthesia was conducted more often during EST of BAO (BAO: 75 (83.3%); MCAO: 18 (31.1%), p < 0.001). Procedure time (BAO: 31 (20–43); MCAO: 27 (18–38); p value 0.226) and fluoroscopy time (BAO: 29 (20–59); MCAO: 29 (17–49), p value 0.317) were comparable. Radiation exposure was significantly higher in patients receiving EST for BAO (BAO: 123.4 (78.7–204.2); MCAO: 94.3 (65.5–163.7), p value 0.046), which represents an increase by 23.7%.


Endovascular stroke treatment of basilar artery occlusions is associated with a higher radiation exposure compared with treatment of middle cerebral artery occlusions.

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