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Outcome of endovascular treatment for acute basilar artery occlusion in the modern era: a single institution experience

  • Interventional Neuroradiology
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Abstract

Purpose

The beneficial effect of endovascular treatment (EVT) for patients with acute basilar artery occlusion (ABAO) remains uncertain. The purpose of the present study was to evaluate clinical outcome of EVT for patients with ABAO and analyze prognostic factors of good outcome.

Methods

From our prospectively established database, we reviewed all patients with ABAO receiving EVT during January 2014 to December 2016. Baseline characteristics and outcomes were evaluated. Favorable functional outcome was defined as modified Rankin Scale score of 0 to 3 assessed at 3-month follow-up. The association between clinical and procedural characteristics and functional outcome was assessed.

Results

Of the 68 patients included, 50 patients (73.5%) received mechanical thrombectomy with stent retriever device. Successful reperfusion (thrombolysis in cerebral infarction grades 2b–3) was achieved in 61 patients (89.7%). Overall favorable functional outcome was reached by 31 patients (45.6%). In univariate analysis, Glasgow Coma Scale sum score, baseline National Institutes of Health stroke scale score (NIHSS), and baseline glycemia level were identified predicting good clinical outcome. Multivariate analysis showed that lower NIHSS was the only independent risk factor of favorable functional outcome (OR 0.832; 95% CI, 0.715–0.968; p = 0.018). No difference of favorable outcomes was observed between the subgroups of time to EVT < 6 h and ≽ 6 h.

Conclusions

Data in the present study suggests that EVT for ABAO patients should be reasonable within 24 h of symptom onset. The most important factor determining clinical outcome is initial stroke severity.

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Authors and Affiliations

  1. Department of Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing, China

    Chuanhui Li, Jian Chen, Guilin Li, Hongqi Zhang, Liqun Jiao & Xunming Ji

  2. Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China

    Wenbo Zhao, Chuanjie Wu, Shuyi Shang, Jiangang Duan, Qingfeng Ma & Yunzhou Zhang

  3. Cerebrovascular Diseases Research Institute, Xuanwu Hospital of Capital Medical University, Beijing, China

    Ming Ren

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  1. Chuanhui Li
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  2. Wenbo Zhao
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Correspondence to Xunming Ji.

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Funding

This study was funded by the Key Research and Development Program of China (Grant number 2016YFC1301502), the National Science Foundation of China (Grant numbers 81601006 and 81701287), the China Postdoctoral Science Foundation and the Beijing Postdoctoral Research Foundation.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Li, C., Zhao, W., Wu, C. et al. Outcome of endovascular treatment for acute basilar artery occlusion in the modern era: a single institution experience. Neuroradiology 60, 651–659 (2018). https://doi.org/10.1007/s00234-018-2011-7

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  • DOI: https://doi.org/10.1007/s00234-018-2011-7

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