PT  - JOURNAL ARTICLE
AU  - Sung Hyun Baik
AU  - Joon Whi Kim
AU  - Byung Moon Kim
AU  - Dong Joon Kim
TI  - Significance of angiographic clot meniscus sign in mechanical thrombectomy of basilar artery stroke
AID  - 10.1136/neurintsurg-2019-015321
DP  - 2020 May 01
TA  - Journal of NeuroInterventional Surgery
PG  - 477--482
VI  - 12
IP  - 5
4099  - http://jnis.bmj.com/content/12/5/477.short
4100  - http://jnis.bmj.com/content/12/5/477.full
SO  - J NeuroIntervent Surg2020 May 01; 12
AB  - Introduction The relationship between the occlusive clot morphology and the efficacy of mechanical thrombectomy (MT) in basilar artery occlusion (BAO) is not well known. Our aim was to evaluate the clinical significance of the clot meniscus sign in patients with acute BAO.Methods 89 patients with acute BAO who underwent MT were retrospectively analyzed. The clot meniscus sign was defined as meniscoid/tram-track like antegrade side-wall contrast opacification of the thrombus. Patients were assigned to two groups based on the presence of the clot meniscus sign. The treatment and clinical outcomes were compared.Results The clot meniscus sign was diagnosed in 62.9% (53/89) of the patients. The meniscus sign (+) group showed a shorter procedure time (55 vs 85 min; p=0.045), higher rate of successful recanalization (89.3% vs 63.6%, p=0.004), higher incidence of first pass effect (32.1% vs 6.1%, p=0.004), and lower number of passes (2 vs 3; p=0.042) when compared with the meniscus sign (−) group. The procedure time (OR 0.972, 95% CI 0.962 to 0.992; p=0.003) and clot meniscus sign (OR 7.920, 95% CI 1.769 to 35.452; p=0.007) were independent predictors of successful recanalization.Conclusion The clot meniscus sign is related to high first pass effect and short procedure time and is a reliable predictor of successful recanalization in patients with acute BAO.