RT Journal Article SR Electronic T1 Significance of angiographic clot meniscus sign in mechanical thrombectomy of basilar artery stroke JF Journal of NeuroInterventional Surgery JO J NeuroIntervent Surg FD BMJ Publishing Group Ltd. SP 477 OP 482 DO 10.1136/neurintsurg-2019-015321 VO 12 IS 5 A1 Baik, Sung Hyun A1 Kim, Joon Whi A1 Kim, Byung Moon A1 Kim, Dong Joon YR 2020 UL http://jnis.bmj.com/content/12/5/477.abstract 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.