Collateral Scores and Outcomes after Endovascular Treatment for Basilar Artery Occlusion

Autor(es)

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]

Afiliação do(s) autor(es)

^[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

• Tipo de documento: Artigo Científico
• Fonte: CEREBROVASCULAR DISEASES; v. 47, n. 5-6, p. 285-290, SEP 2019.
• Citações Web of Science: 1

Resumo

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)

• Processo FAPESP: 16/15236-8 - Estudo de cooperação internacional para o tratamento de oclusão aguda da artéria basilar
• Beneficiário: Octávio Marques Pontes-Neto
• Modalidade de apoio: Auxílio à Pesquisa - Pesquisa em Políticas Públicas para o SUS