PT  - JOURNAL ARTICLE
AU  - Jiaxing Song
AU  - Jiacheng Huang
AU  - Linyu Li
AU  - Jie Yang
AU  - Chengsong Yue
AU  - Shuai Liu
AU  - Weilin Kong
AU  - Xiaojun Luo
AU  - Jiasheng Liao
AU  - Jie Du
AU  - Bo Song
AU  - Jiazuo Liu
AU  - Xiaolong Tian
AU  - Xiaolin Tan
AU  - Fengli Li
AU  - Wenjie Zi
TI  - Locked-in syndrome responding to endovascular treatment
AID  - 10.1136/jnis-2022-019112
DP  - 2023 Aug 01
TA  - Journal of NeuroInterventional Surgery
PG  - 808--813
VI  - 15
IP  - 8
4099  - http://jnis.bmj.com/content/15/8/808.short
4100  - http://jnis.bmj.com/content/15/8/808.full
SO  - J NeuroIntervent Surg2023 Aug 01; 15
AB  - Background Locked-in syndrome (LiS) is a rare and devastating condition in patients with acute basilar artery occlusion. However, the benefits of endovascular treatment (EVT) for LiS remain unclear.Objective To assess the outcomes associated with EVT and identify the factors associated with outcomes of LiS.Methods We used the data of the Endovascular Treatment for Acute Basilar Artery Occlusion Study Registry (BASILAR) from 47 tertiary stroke centers in China. The included patients had LiS and received EVT or standard medical treatment (SMT) alone. The primary outcome was improvement in the modified Rankin Scale (mRS) score at 90 days.Results Among the 120 patients with LiS, 92 (76.7%) received EVT and 28 (23.3%) received SMT. Compared with SMT, EVT was associated with improved mRS score (common OR (cOR)=2.68 (95% CI 1.16 to 6.20); p=0.02) and decreased mortality (aOR=0.35 (95% CI 0.13 to 0.90); p=0.03). Moreover, the benefit of EVT for LiS was sustained for at least 1 year (p=0.008). Higher baseline posterior circulation Alberta Stroke Prognosis Early CT Score (pc-ASPECTS, aOR=2.04 (95% CI 1.34 to 3.10); p<0.001) and absence of pneumonia (aOR=0.26 (95% CI 0.08 to 0.90); p=0.03) were significantly associated with favorable functional outcome at 90 days in patients who received EVT, while lower pc-ASPECTS (aOR=0.52 (95% CI 0.36 to 0.76); p<0.001) was associated with increased 90-day mortality.Conclusions This study found that EVT was associated with favorable functional outcomes and decreased mortality among patients with LiS. Baseline pc-ASPECTS and pneumonia were independent predictors of outcomes.Data are available upon reasonable request.