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Basilar artery on computed tomography angiography score and clinical outcomes in acute basilar artery occlusion

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Abstract

Objectives

This study aimed to evaluate the safety and efficacy of mechanical thrombectomy (MT) in patients with acute basilar artery occlusion (BAO) based on the baseline Basilar Artery on Computed Tomography Angiography (BATMAN) score.

Methods

We selected patients from the BASILAR study and analyzed the effects and safety of standard medical therapy (SMT) and MT for patients with documented BATMAN scores. The patients were subgrouped according to their BATMAN score (0–3, 4–6, and 7–10). The primary outcome was a favorable functional outcome (modified Rankin Scale [mRS] ≤ 3) and mortality after 90 days.

Results

This study included 828 patients: 337 with poor BATMAN scores (0–3), 386 with moderate BATMAN scores (4–6), and 105 with good BATMAN scores (7–10). MT was associated with favorable functional outcomes in the poor (adjusted odds ratio [aOR], 11.96; 95% confidence interval [CI], 2.58–55.43; P = 0.002), moderate (aOR, 4.66; 95% CI, 2.11–10.28; P < .001), and good (aOR, 7.71; 95% CI, 2.20–27.02; P = 0.001) BATMAN score subgroups. MT was also associated with low mortality rates in the poor (aOR, 0.10; 95% CI, 0.04–0.27; P < 0.001) and moderate (aOR, 0.31; 95% CI, 0.16–0.57; P = 0.002) BATMAN score subgroups. The BATMAN score was significantly associated with favorable outcomes in both the SMT (aOR, 1.44; 95% CI, 1.08–1.93; P = 0.014) and MT (aOR, 1.31; 95% CI, 1.20–1.44; P < 0.001) groups.

Conclusion

Higher BATMAN scores were associated with improved prognosis and lower mortality rates after 3 months. MT was associated with improved outcomes in patients with low BATMAN scores despite their worse overall outcomes.

Unique identifier

ChiCTR1800014759, 2018/02/03.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Code availability

Not applicable.

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Acknowledgements

We would like to thank Editage (www.editage.cn) for English language editing.

Funding

This study was funded by the National Natural Science Foundation of China (no. 82071323), Chongqing Natural Science Foundation (no. cstc2020jcyj-msxmX0926), Chongqing Science and Health Joint Project (no. 2019ZDXM002), the Army Medical University Clinical Medical Research Talent Training Program (nos. 2018XLC3039, 2019XLC2008, and 2019XLC3016), and Medical and Health Planning Project of Xiamen (no. 3502z20209036).

Author information

Author notes

  1. Kangjia Song, Fengli Li and Mingchao Shi have contributed equally.

Authors and Affiliations

  1. Department of Neurology and Neuroscience, The First Hospital of Jilin University, No. 1 Xinmin Street, Changchun, Jilin, 130021, China

    Kangjia Song, Mingchao Shi, Feixue Yue, Chao Li, Shuang Qi & Shouchun Wang

  2. Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), No. 183 Xinqiao Main Street, Shapingba District, Chongqing, 400037, China

    Fengli Li & Wenjie Zi

  3. Department of Neurology, Chongzhou People’s Hospital, Chongzhou, Sichuan, China

    Youlin Wu

  4. Department of Neurology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China

    Zhengzhou Yuan

  5. Department of Neurology, The First People’s Hospital of Zigong, Zigong, Sichuan, China

    Qiang Shi

  6. Department of Neurology, Xuzhou Central Hospital, Xuzhou, Jiangsu, China

    Xinmin Fu

  7. Department of Neurology, Hubei Zhongshan Hospital, Wuhan, Hubei, China

    Yue Wan

  8. Department of Neurology, Hubei Province People’s Hospital, Wuhan, Hubei, China

    Jie Pu

  9. Department of Neurology, Guiping People’s Hospital, Guiping, Guangxi, China

    Wencheng He

  10. Department of Neurology, Ganzhou People’s Hospital, Ganzhou, Jiangxi, China

    Guoyong Zeng

  11. Department of Neurology, Wuhan No. 1 Hospital, Wuhan, Hubei, China

    Zhangbao Guo

Authors
  1. Kangjia Song
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  2. Fengli Li
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  3. Mingchao Shi
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  16. Wenjie Zi
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  17. Shouchun Wang
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Corresponding authors

Correspondence to Wenjie Zi or Shouchun Wang.

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The authors declare that they have no conflict of interest.

Ethical approval

Approval was obtained from the ethics committee of the participating centers. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in the study or their legally authorized representatives.

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All included patients gave their consent for publication of the collected data.

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Song, K., Li, F., Shi, M. et al. Basilar artery on computed tomography angiography score and clinical outcomes in acute basilar artery occlusion. J Neurol 269, 3810–3820 (2022). https://doi.org/10.1007/s00415-022-11013-1

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  • DOI: https://doi.org/10.1007/s00415-022-11013-1

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