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Acute Basilar Artery Occlusion in the Basilar Artery International Cooperation Study : Does Gender Matter? Marcel Arnold, Urs Fischer, Annette Compter, Jan Gralla, Oliver Findling, Heinrich P. Mattle, L. Jaap Kappelle, David Tanne, Ale Algra and Wouter J. Schonewille Stroke. 2010;41:2693-2696; originally published online October 14, 2010; doi: 10.1161/STROKEAHA.110.594036

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Acute BasilarArtery Occlusion in the Basilar Artery International Cooperation Study
Does Gender Matter?
Marcel Arnold, MD; Urs Fischer, MD; Annette Compter, MD; Jan Gralla, MD; Oliver Findling, MD; Heinrich P. Mattle, MD; L. Jaap Kappelle, MD; David Tanne, MD; Ale Algra, MD; Wouter J. Schonewille, MD; on behalf of the BASICS Study Group
Background and Purpose—Randomized trials suggested a different benefit ofintravenous thrombolysis (IVT) and intra-arterial thrombolysis (IAT) between men and women with anterior circulation stroke because of a worse outcome of women in the control group. Methods—We compared outcome and recanalization in men and women with basilar artery occlusion treated with antithrombotic treatment alone, IVT or combined IVT–IAT, or IAT in the Basilar Artery International CooperationStudy. Results—Overall, 389 male and 226 female patients were analyzed. In the antithrombotic treatment group, 68 of 111 (61%) men and 47 of 70 (67%) women had a poor outcome defined as a modified Rankin Scale score of 4 to 6 (adjusted risk ratio [aRR], 0.96; 95% CI, 0.75 to 1.24), in the IVT/combined IVT–IAT group, 47 of 77 (61%) men and 24 of 43 (56%) women (aRR, 1.19; 95% CI, 0.89 to 1.60),and in the IAT group, 142 of 185 (77%) men and 71 of 102 (70%) women (aRR, 1.01; 95% CI, 0.88 to 1.17). Mortality was not different between men and women in the antithrombotic treatment group (aRR, 0.80; 95% CI, 0.55 to 1.16), the IVT/combined IVT–IAT group (aRR, 1.11; 95% CI, 0.72 to 1.73), or in the IAT group (aRR, 1.01; 95% CI, 0.75 to 1.36). Insufficient recanalization after combined IVT–IAT orIAT was similar in men and women (23% versus 22%; aRR, 0.92; 95% CI, 0.58 to 1.46). Conclusions—In patients with acute basilar artery occlusion, no significant gender differences for outcome and recanalization were observed, regardless of treatment modality. (Stroke. 2010;41:2693-2696.) Key Words: gender acute stroke basilar artery occlusion thrombolysis

n previous studies on patients withacute stroke, genderbased differences have been observed with respect to clinical presentation, management, and outcomes.1 Studies on patients with ischemic stroke not treated with thrombolysis reported less favorable outcomes for women than for men.2 Further, it has been reported that women benefited more from intravenous thrombolysis (IVT) and intra-arterial thrombolysis (IAT) than men.3,4 The...