Basilar artery thrombectomy: assessment of outcome and identification of prognostic factors
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Mechanical thrombectomy (MT) has been demonstrated as an effective treatment for acute ischemic stroke (AIS), thanks to large vessel occlusion (LVO), especially in case of anterior cerebral artery with many randomized clinical trials (RCTs) every year. On the other hand, there is a limited number of basilar artery occlusion (BAO)-related studies which have been conducted. The fact prompts our range of case studies, which furnish BAO understanding with our experience, results and some prognosis factors of MT. This retrospective and single-center study was conducted on 22 patients who were diagnosed with BAO and underwent the treatment of MT from October 2012 to January 2018. Clinical feature such as radiological imaging, procedure complications, and intracranial hemorrhage were all documented and evaluated. All the studies’ results based on performance using modified Rankin scale score (mRS) and mortality at 90 days. The results from these BAO patients study indicated that the posterior circulation Acute Stroke Prognosis Early CT Score (pcASPECTS) recorded before the intervention was 7.7 ± 1.6, while the admission National Institutes of Health Stroke Scale (NIHSS) was 17.5 ± 5.4. 15/22 cases achieved successful recanalization (TICI, Thrombolysis in Cerebral Infarction scale, of 2b–3), accounting for 68.2%. The results highlighted 50% of the favorable outcome (mRS 0–2) occupying 11 out of 22 patients in total and the overall mortality was 36.4%. The intracranial hemorrhagic complication was detected in three cases (13.6%). Placing in juxtaposition the poor-outcome group and the favorable-outcome group, we could witness statistically significant difference (P < 0.05) suggesting both good baseline image (pc-ASPECTS ≥ 7) and recanalization (TICI 2b–3) were two good prognosis factors. Our case series showed that MT would be an effective and feasible treatment for BAO. The pre-procedural pcASPECTS ≥ 7 and post-procedural good recanalization (TICI 2b–3) were two important prognosis factors for predicting good clinical outcome.
KeywordsBasilar artery occlusion Acute ischemic stroke Mechanical thrombectomy
We would like to thank MSc. Phuong Linh Nguyen (an English editor in biomedicine) for checking and improving the English in the revised manuscript.
ATT, HAN and DLV, MTP, CT, HKL, QAN, TTN, TTN designed, performed experiments and collected data and informed consents. ATT and TCD, JC and DTC analyzed and interpreted the results. ATT, HNA TCD and DTC wrote the manuscript. TCD, PLS, JC, YT and DTC edited the manuscript. All authors approved the final manuscript.
No funding was received.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in 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. The research was approved by the institutional review board of Bach Mai Hospital.
Relatives of all patients have been explained the procedure and agreed to participate in treatment. Informed consents were obtained from relatives of the patients included in the study.
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