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Thrombectomy for Posterior Circulation Stroke: Predictors of Outcomes in a Brazilian Registry.

Authors :
Pazuello, Guilherme Borghini
de Castro-Afonso, Luís Henrique
Fornazari, Vitor Rodrigues
Nakiri, Guilherme Seizem
Abud, Thiago Giansante
Monsignore, Lucas Moretti
Dias, Francisco Antunes
Martins-Filho, Rui Kleber
Camilo, Milene Rodrigues
Aléssio-Alves, Frederico Fernandes
Pontes-Neto, Octávio Marques
Abud, Daniel Giansante
Source :
World Neurosurgery. Mar2021, Vol. 147, pe363-e372. 10p.
Publication Year :
2021

Abstract

Acute basilar artery occlusion is a devastating life-threatening condition. Early recanalization is the therapeutic goal in patients with acute ischemic stroke. Despite the high rates of recanalization achieved with modern devices for basilar occlusions, many patients have had poor clinical outcomes. This study aimed to assess the predictors of good and poor outcomes among patients with basilar artery occlusion treated with thrombectomy. A consecutive registry of 80 patients was included in this retrospective study. The primary end point was to access variables associated with neurologic outcomes defined by a modified Rankin Scale (mRS) score of 0–2, symptomatic intracranial hemorrhage (sICH), and mortality at 3 months follow-up. Recanalization was achieved in 86.2%, and the sICH rate was 8.7%. A good neurologic outcome (mRS score 0–2) was observed in 26.2% and a moderate outcome (mRS score 0–3) in 32.5% of patients. The mortality was 38.7% at 3 months follow-up. After thrombectomy for posterior circulation strokes, young patients, V4–proximal basilar occlusion, (high) baseline posterior circulation Alberta Stroke Program Early CT Score, and complete recanalization were independent predictors of good neurologic outcomes. Failure to recanalize was strongly related to sICH and mortality. In addition, diabetes, atrial fibrillation, and baseline National Institutes of Health Stroke Scale scores ≥10 had an independent association with mortality. This study contributes to the knowledge required to optimize recanalization treatments for posterior circulation strokes and may help to improve future clinical studies. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
18788750
Volume :
147
Database :
Academic Search Index
Journal :
World Neurosurgery
Publication Type :
Academic Journal
Accession number :
149074978
Full Text :
https://doi.org/10.1016/j.wneu.2020.12.060