Predictors of Good Outcome After Stent-Retriever Thrombectomy in Acute Basilar Artery Occlusion

• Published in: Stroke (1970) Vol. 46; no. 10; pp. 2972 - 2975
• Main Authors: Yoon, Woong, Kim, Seul Kee, Heo, Tae Wook, Baek, Byung Hyun, Lee, Yun Young, Kang, Heoung Keun
• Format: Journal Article
• Language: English
• Published: United States American Heart Association, Inc 01.10.2015
• Subjects: Acute Disease; Aged; Aged, 80 and over; Brain Infarction - diagnostic imaging; Brain Infarction - pathology; Brain Infarction - surgery; Cohort Studies; Diffusion Magnetic Resonance Imaging; Endovascular Procedures; Female; Humans; Logistic Models; Male; Middle Aged; Odds Ratio; Prognosis; Retrospective Studies; Severity of Illness Index; Stents; Thalamus - blood supply; Thalamus - diagnostic imaging; Thalamus - pathology; Thrombectomy - methods; Tomography, X-Ray Computed; Treatment Outcome; Vertebrobasilar Insufficiency - diagnostic imaging; Vertebrobasilar Insufficiency - pathology; Vertebrobasilar Insufficiency - surgery; basilar artery; infarction; diffusion magnetic resonance imaging; confidence intervals; thrombectomy
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/STROKEAHA.115.010840

BACKGROUND AND PURPOSE—Factors related to prognosis after a modern mechanical thrombectomy in patients with acute basilar artery occlusion remain unclear. This study investigated the prognostic factors for patients with acute basilar artery occlusion who underwent a stent-retriever thrombectomy. METHODS—We analyzed clinical and pretreatment diffusion-weighted imaging (DWI) data in 50 consecutive patients with acute basilar artery occlusion treated with stent-retriever thrombectomy. A good outcome was defined as a modified Rankin Scale score of 0 to 2 at 3 months. The association between clinical and DWI parameters and functional outcome was evaluated with logistic regression analysis. RESULTS—In a univariate analysis, the following variables were significantly associated with outcomeage, hypertension, baseline National Institutes of Health Stroke Scale, posterior circulation Acute Stroke Prognosis Early CT Score on a pretreatment DWI, posterior circulation Acute Stroke Prognosis Early CT Score of ≥7 (versus <7), thalamic infarction, and bilateral thalamic infarction. In a multivariate model, only a low initial National Institutes of Health Stroke Scale score (odds ratio, 0.82; 95% confidence interval, 0.709–0.949; P=0.008) and high DWI posterior circulation Acute Stroke Prognosis Early CT Score (odds ratio, 1.854; 95% confidence interval 1.012–3.397; P=0.045) were significant independent predictors of good outcome. In a univariate analysis, bilateral thalamic infarction was associated with a poor outcome (odds ratio, 1.993; 95% confidence interval, 1.187–3.346; P=0.035) but not with a unilateral thalamic infarction (P=0.525). CONCLUSIONS—This study suggested that initial infarction severity and posterior circulation Acute Stroke Prognosis Early CT Score on a pretreatment DWI are independent predictors of clinical outcome after stent-retriever thrombectomy in patients with acute basilar artery occlusion.