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Abstract
Background Patients with acute basilar artery occlusion (ABAO) who undergo combined standard medical treatment (SMT) and endovascular thrombectomy (EVT) may still have unsatisfactory outcomes. This study was conducted to identify the factors that may impact their outcomes.
Methods We retrospectively reviewed the data of all patients with ABAO combined with SMT and EVT in the endovascular treatment for acute basilar artery occlusion (ATTENTION) trial. A good outcome is defined as a modified Rankin Scale (mRS) score of 0–3, a poor outcome as mRS score of 4–6, and mortality as death at 90-day follow-up. The study analyzed various factors influencing the patients’ good outcomes and mortality.
Results The study included 221 patients (148 men and 73 women). Among these patients, 45.7% achieved an mRS score of 0–3, while the overall mortality rate was 37.1% (82/221). A good outcome was significantly associated with younger age (adjusted OR 0.96; 95% CI 0.93 to 0.99; P=0.019), a baseline posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS) of 8–10 (adjusted OR 2.34; 95% CI 1.07 to 5.12; P=0.034), and post-procedure pc-ASPECTS of 8–10 (adjusted OR 1.40; 95% CI 1.07 to 1.84; P=0.013). Additionally, time from puncture to reperfusion (adjusted OR 2.02; 95% CI 1.2 to 3.41; P=0.008) and intracranial hemorrhage (adjusted OR 3.59; 95% CI 1.09 to 11.8; P=0.035) were associated with 90-day mortality.
Conclusions Younger age, baseline pc-ASPECTS of 8–10, and higher post-procedure pc-ASPECTS could effectively predict good outcomes for patients with ABAO undergoing EVT. Additionally, a prolonged time from puncture to reperfusion and intracranial hemorrhage can independently predict mortality.
Trial registration number NCT04751708.
- artery
- angioplasty
- intervention
- thrombectomy
Data availability statement
Data are available upon reasonable request.
Statistics from Altmetric.com
Data availability statement
Data are available upon reasonable request.
Footnotes
JS and XH contributed equally.
Collaborators A complete list of sites and investigators in the ATTENTION trial is provided in the online supplemental appendix table S1. Wei Hu, Xinfeng Liu, Guoping Wang, Raul G Nogueira, Adnan I Qureshi, Blaise W Baxter, Gelin Xu, Xiaoyan Yan, Feng Gao, Liqun Jiao, Sen Qun, Zi Wang, Juan Chen, Ruidong Ye, Yongwei Zhang, Cangjun Wu, Rui Li, Chuanqing Fang, Kexue Deng, Shuya Yuan, Menglong Zheng, Hongbing Chen, Guang Zhang, Wei Bao, Wei Hu, Xinfeng Liu, Guoping Wang, Raul G Nogueira, Adnan I Qureshi, Blaise W Baxter, Hongxing Han, Guangxiong Yuan, Changming Wen, Peiyang Zhou, Wenhuo Chen, Guoyong Zeng, Hui Xu, Yuwen Li, Zhengfei Ma, Chuanqing Yu, Junfeng Su, Zhiming Zhou, Zhongjun Chen, Geng Liao, Yaxuan Sun, Youquan Ren, Hui Zhang, Jie Chen, Xincan Yue, Xiuyao Ma, GuoDong Xiao, Li Wang, Rui Liu, Weimin Yang, Wenhua Liu, Yong Liu, Fuqiang Guo, Xueli Cai, Bo Yin, Jinglun Li, Pu Fang, Chunyun Shen, Chuyuan Ni, Hui Wang, Liang Liu, Kai Li, Tao Cui, Hao Wang, Jun Gao, Tingyu Yi, Youmeng Wang, Tao Wang, Xueying Shi, Zhihua Cao, Chen Long, Li Chen, Chi Zhang, Gichao Zhai, Xia Zhang, Xiushan Liang, Qingsong Li, Yuhan Meng, Jianbo Tao, Zhenzhu Zhu, Yuedong Cheng, Meng Zhang, Tong Zhou, Jing Wang, Yali Zhang.
Contributors JS, XH, and DG designed and conceived this study. DG and YZ conducted data analysis and interpretation. LC, XT, SX, and SH were involved in patient recruitment and monitored the collecting of clinical data. JS and XH wrote the first draft of the manuscript. All authors were involved in investigating the clinical data. Guarantor: DG. All authors reviewed and edited the manuscript and approved the final manuscript.
Funding The ATTENTION Registry was funded by the Program for Innovative Research Team of the First Affiliated Hospital of the University of Science and Technology of China, the Beijing Dingyi Foundation (China Special Fund for Stroke Prevention and Treatment), and the Beijing Healthunion Cardio-Cerebrovascular Disease Prevention and Treatment Foundation.
Disclaimer The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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