title: Dominant vertebral artery status and functional outcome after endovascular therapy of symptomatic basilar artery occlusion.
abstract: OBJECTIVE
  To determine whether status of dominant vertebral artery could affect clinical outcome in patients with symptomatic basilar artery occlusion (BAO).
  
  
  METHODS
  We reviewed patients with symptomatic BAO who underwent endovascular treatment at the institute between January 2007 and July 2014. Patients were categorized into 2 groups according to functional outcome and baseline characteristics, treatment related factors were compared. Variables including clinical and imaging parameters were also compared according to the dominant V1 lesion.
  
  
  RESULTS
  Fifty-nine of 101 patients underwent endovascular treatment and 23 patients (39.0%) showed favorable outcome (modified Rankin score ≤3 at 3 month). Younger age, male sex, lower baseline NIHSS score, higher PC-ASPECTS, absence of hemorrhagic transformation, shorter procedure time, and complete recanalization were associated with favorable outcome. Procedure time tended to be longer in patients with dominant V1 lesion (130.0; range, 105.0-179.0 vs. 101.5; range, 48.0-138.0, P=0.05). Among patients with large artery disease (LAD), higher initial NIHSS, and clinical manifestation of decreased mental status were significantly associated with dominant V1 lesion. Endovascular procedure time tended to be longer, distal basilar occlusion tended to be more frequent, and proportion of the patients with complete recanalization tended to be less in patient with dominant V1 lesion. Poor outcome tended to be more frequent in dominant V1 lesion with LAD (88.9% vs. 42.9%, P=0.05). These findings were comparable in patients who underwent mechanical thrombectomy.
  
  
  CONCLUSIONS
  Dominant V1 steno-occlusion may be associated with poor functional outcome in patients with the symptomatic BAO. Status of dominant VA and various treatment strategy should be considered when performing endovascular treatment for recanalization in patients with symptomatic BAO.
authors.affiliation: Department of Neurology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.
authors.forename: Jun Young
authors.initials: JY
authors.lastname: Chang
authors.affiliation: Department of Neurology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.
authors.forename: Seunguk
authors.initials: S
authors.lastname: Jung
authors.affiliation: Department of Radiology, Seoul National University Bun-Dang Hospital, Seongnam, Republic of Korea.
authors.forename: Cheolkyu
authors.initials: C
authors.lastname: Jung
authors.affiliation: Department of Neurology, Seoul National University Bun-Dang Hospital, Seongnam, Republic of Korea.
authors.forename: Hee-Joon
authors.initials: HJ
authors.lastname: Bae
authors.affiliation: Department of Neurosurgery, Seoul National University Bun-Dang Hospital, Seongnam, Republic of Korea.
authors.forename: Oki
authors.initials: O
authors.lastname: Kwon
authors.affiliation: Department of Neurology, Seoul National University Bun-Dang Hospital, Seongnam, Republic of Korea. Electronic address: mkhan@snu.ac.kr.
authors.forename: Moon-Ku
authors.initials: MK
authors.lastname: Han
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001488:Basilar Artery / Q000000981:diagnostic imaging* / Q000473:pathology*; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000000981:diagnostic imaging* / Q000473:pathology*; D014715:Vertebrobasilar Insufficiency / Q000473:pathology / Q000628:therapy*
keywords: Basilar artery; Cerebrovascular occlusion; Outcome; Vertebral artery