Predictors of Good Outcome After Stent-Retriever Thrombectomy in Acute Basilar Artery Occlusion.
OBJECTIVE
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 outcome: age, 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.
From the Department of Radiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea. radyoon@jnu.ac.kr.
Woong
W
Yoon
From the Department of Radiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea.
Seul Kee
SK
Kim
From the Department of Radiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea.
Tae Wook
TW
Heo
From the Department of Radiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea.
Byung Hyun
BH
Baek
From the Department of Radiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea.
Yun Young
YY
Lee
From the Department of Radiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea.
Heoung Keun
HK
Kang
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D020520:Brain Infarction / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D038524:Diffusion Magnetic Resonance Imaging; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015607:Stents; D013788:Thalamus / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D017131:Thrombectomy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*
basilar artery; confidence intervals; diffusion magnetic resonance imaging; infarction; thrombectomy