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Original research
Initial factors affecting the clinical outcome after successful recanalization via MR-based mechanical thrombectomy in patients with acute ischemic stroke due to basilar artery occlusion
  1. Seungnam Son1,2,
  2. Yong-Won Kim3,4,
  3. Min Kyun Oh2,5,
  4. Soo-Kyoung Kim1,2,
  5. Ki-Jong Park1,
  6. Nack-Cheon Choi1,2,
  7. Oh-Young Kwon1,
  8. Byeong Hoon Lim1,2,
  9. Ho Cheol Choi6,
  10. Dae Seob Choi2,6
  1. 1Department of Neurology, Gyeongsang National University, School of Medicine, Jinju, Korea
  2. 2Gyeongnam Regional Cardiocerebrovascular Disease Center, Jinju, Korea
  3. 3Department of Neurology, Kyungpook National University, School of Medicine, Daegu, Korea
  4. 4Cerebrovascular Center, Kyungpook National University Hospital, Daegu, Korea
  5. 5Department of Rehabilitation Medicine, Gyeongsang National University, School of Medicine, Jinju, Korea
  6. 6Department of Radiology, Gyeongsang National University, School of Medicine, Jinju, Korea
  1. Correspondence to Dr Dae Seob Choi, Department of Radiology, Gyeongsang National University School of Medicine, 79 Gangnam-ro, Jinju 660-702, South Korea; brevis1{at}nate.com

Abstract

Background and purpose To determine the initial factors, including patient characteristics, stroke etiology and severity, time factors, and imaging findings, that could affect the clinical outcome of patients with acute ischemic stroke (AIS) caused by basilar artery occlusion (BAO) where successful recanalization was achieved via mechanical thrombectomy.

Methods Between March 2011 and December 2014, 35 patients with AIS caused by BAO received MRI/MR angiography-based mechanical thrombectomies, and recanalization was achieved with a Thrombolysis In Cerebral Infarction score of >2b. The patients were divided into a good outcome group (n=19), defined as those with a modified Rankin Scale (mRS) score of 0–2 at 3 months after stroke onset, and a poor outcome group (n=16), defined as a mRS score of 3–6. The differences between the groups were analyzed.

Results Initial National Institutes of Health Stroke Scale (NIHSS) score (good vs poor: 17.9±8.9 vs 27.6±8.5, p=0.003), posterior circulation Acute Stroke Prognosis Early CT Score (pc-ASPECTS) based on initial diffusion-weighted images (DWI) (good vs poor: 7.8±1.6 vs 5.4±1.8, p=0.001), pc-ASPECTS based on contrast staining on the post-thrombectomy control CT (good vs poor: 9.2±1.5 vs 6.3±2.2, p<0.001), and presence of contrast staining in the brainstem on that CT (good vs poor: 15.8% vs 81.6%, p<0.001) were significantly different between the groups.

Conclusions Patients with AIS caused by BAO with a lower initial NIHSS score, fewer lesions on initial DWI, and less contrast staining on the post-thrombectomy control CT have higher probabilities of a good clinical outcome after successful recanalization via a mechanical thrombectomy.

  • MRI
  • Stroke
  • Thrombectomy
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