• Tadahiro Ishiwada, Kyohei Fujita, Sakyo Hirai, Shoko Fujii, Hiroto Yamaoka, Mariko Ishikawa, Masataka Yoshimura, Keigo Shigeta, Yohei Sato, Kana Sawada, Kenji Yamada, Toshihiro Yamamura, Yosuke Ishii, Yoshiki Obata, Osamu Tone, Mutsuya Hara, Yoshihisa Kawano, Masaru Aoyagi, Shigeru Nemoto, Taketoshi Maehara, and Kazutaka Sumita.
• Department of Endovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan; Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan; Department of Neurosurgery, Shioda Memorial Hospital, Chiba, Japan.
• World Neurosurg. 2023 Mar 1; 171: e506e515e506-e515.

Background And PurposeTo measure the magnitude of the effect of the infarct location measured using the posterior circulation Alberta Stroke Program Early Computed Tomographic Score (pc-ASPECTS) on the functional outcome at 90 days in patients with basilar artery (BA) occlusion undergoing endovascular therapy (EVT).MethodsOf the acute ischemic stroke patients undergoing EVT for acute posterior circulation large vessel occlusion enrolled in the multicenter observational registry from December 2013 to February 2021, patients with BA occlusion were included. A favorable outcome was defined as achieving a modified Rankin Scale score of 0-3 at 90 days. The effect of pc-ASPECTS including the distribution on favorable outcomes was evaluated.ResultsOne hundred patients were analyzed. Fifty-one patients (51%) achieved favorable outcome. Patients achieving a favorable outcome were younger, had a lower National Institutes of Health Stroke Scale score before EVT, and had a higher pc-ASPECTS before EVT than those not achieving a favorable outcome. Multivariable logistic analysis showed a significant association between higher pc-ASPECTS and a favorable outcome (odds ratio [OR] 1.24; 95% confidence interval [CI] 1.02-1.52; P = 0.028). Considering the infarct location, bilateral cerebellar infarction was significantly associated with a lower frequency of favorable outcomes than those without cerebellar infarction (OR 0.16; 95% CI 0.04-0.51; P = 0.002).ConclusionsA higher pc-ASPECTS before EVT could be a predictor of a favorable outcome after EVT for BA occlusion. In particular, the presence of bilateral cerebellar infarction before EVT was significantly associated with a lower likelihood of a favorable outcome.Copyright © 2022 Elsevier Inc. All rights reserved.

18 keywords...

hide…