| Full text | |
| Author(s): |
Dias, Francisco Antunes
[1]
;
Castro-Afonso, Luis Henrique
[2]
;
Zanon Zotin, Maria Clara
[2]
;
Alessio-Alves, Frederico Fernandes
[1]
;
do Vale Martins Filho, Rui Kleber
[1]
;
Camilo, Millene Rodrigues
[1]
;
Nakiri, Guilherme Seizem
[2]
;
Abud, Daniel Giansante
[2]
;
Pontes-Neto, Octavio Marques
[1]
Total Authors: 9
|
| Affiliation: | [1] Univ Sao Paulo, Ribeirao Preto Med Sch, Hosp Clin, Dept Neurosci & Behav Sci, Ribeirao Preto - Brazil
[2] Univ Sao Paulo, Ribeirao Preto Med Sch, Hosp Clin, Div Radiol, Dept Internal Med, Ribeirao Preto - Brazil
Total Affiliations: 2
|
| Document type: | Journal article |
| Source: | CEREBROVASCULAR DISEASES; v. 47, n. 5-6, p. 285-290, SEP 2019. |
| Web of Science Citations: | 1 |
| Abstract | |
Background: Basilar artery occlusion (BAO) is a rare stroke subtype with high mortality rates. Best BAO reperfusion strategy is still controversial. Objective: We aim to describe outcomes of BAO patients submitted to mechanical thrombectomy (MT) in a comprehensive stroke center in Brazil and analyze which previous published computed tomography angiography (CTA) collateral score better predict functional outcomes. Methods: Retrospective analysis of consecutive BAO patients. CTA was used to evaluate the posterior circulation collateral score (PC-CS), the basilar artery on CTA score, and for the presence of posterior communicating arteries. A favorable outcome was defined as modified Rankin Score <= 3 at 90-days. After univariate analyses, multivariate logistic regression was used to identify if any collateral score independently predicts favorable outcomes. Results: Between January 2011 and April 2017, 27 (85% male) BAO patients with median NIHSS 26 (IQR 15-32) were identified. Twenty-five (93%) patients were treated with MT devices, and only 2 (7%) patients were treated with angioplasty and stenting. Successful recanalization rate was 85%, and only 1 (3.7%) patient had symptomatic hemorrhagic transformation. Favorable outcomes were reached in 10 (37%) patients. In univariate analysis, female sex, NIHSS, Glasgow coma scale, mild-to-moderate symptoms on admission, onset-to-groin time, and PC-CS predicted favorable outcomes. In multivariate analysis, PC-CS (OR 1.69; 95% CI 1.10-2.60; p = 0.016) and NIHSS (OR 0.84; 95% CI 0.77-0.93; p = 0.001) remained the only independent predictors of favorable outcomes. The PC-CS AUC was 0.80 (95% CI 0.62-0.98; p = 0.012). Conclusions: MT is a promising strategy for BAO treatment. Among collateral scores, PC-CS was the only independent predictor of favorable outcomes in the present study. (AU) | |
| FAPESP's process: | 16/15236-8 - Basilar artery international cooperation study |
| Grantee: | Octávio Marques Pontes-Neto |
| Support Opportunities: | Research Grants - Research in Public Policies for the National Health Care System (PP-SUS) |