AI Article Synopsis
- Patients with acute basilar artery occlusion (ABAO) who receive standard medical treatment (SMT) and endovascular thrombectomy (EVT) often have poor outcomes, motivating a study to identify influencing factors.
- The study analyzed outcomes for 221 patients, finding that 45.7% had good results defined by a modified Rankin Scale (mRS) score of 0-3, while 37.1% died within 90 days.
- Key factors for good outcomes included younger age, higher Alberta Stroke Program Early CT Score (pc-ASPECTS) both before and after procedure, while mortality was linked to longer time from puncture to reperfusion and presence of intracranial hemorrhage.
Article Abstract
Background: Patients with acute basilar artery occlusion (ABAO) who undergo combined standard medical treatment (SMT) and endovascular thrombectomy (EVT) may still have unsatisfactory outcomes. This study was conducted to identify the factors that may impact their outcomes.
Methods: We retrospectively reviewed the data of all patients with ABAO combined with SMT and EVT in the endovascular treatment for acute basilar artery occlusion (ATTENTION) trial. A good outcome is defined as a modified Rankin Scale (mRS) score of 0-3, a poor outcome as mRS score of 4-6, and mortality as death at 90-day follow-up. The study analyzed various factors influencing the patients' good outcomes and mortality.
Results: The study included 221 patients (148 men and 73 women). Among these patients, 45.7% achieved an mRS score of 0-3, while the overall mortality rate was 37.1% (82/221). A good outcome was significantly associated with younger age (adjusted OR 0.96; 95% CI 0.93 to 0.99; P=0.019), a baseline posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS) of 8-10 (adjusted OR 2.34; 95% CI 1.07 to 5.12; P=0.034), and post-procedure pc-ASPECTS of 8-10 (adjusted OR 1.40; 95% CI 1.07 to 1.84; P=0.013). Additionally, time from puncture to reperfusion (adjusted OR 2.02; 95% CI 1.2 to 3.41; P=0.008) and intracranial hemorrhage (adjusted OR 3.59; 95% CI 1.09 to 11.8; P=0.035) were associated with 90-day mortality.
Conclusions: Younger age, baseline pc-ASPECTS of 8-10, and higher post-procedure pc-ASPECTS could effectively predict good outcomes for patients with ABAO undergoing EVT. Additionally, a prolonged time from puncture to reperfusion and intracranial hemorrhage can independently predict mortality.
Trial Registration Number: NCT04751708.
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| http://dx.doi.org/10.1136/jnis-2023-021057 | DOI Listing |
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