Thrombectomy for Posterior Circulation Stroke: Predictors of Outcomes in a Brazilian Registry.

Autor: Pazuello GB; Division of Interventional Neuroradiology, Department of Radiology, Hematology and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil., de Castro-Afonso LH; Division of Interventional Neuroradiology, Department of Radiology, Hematology and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. Electronic address: castroafonsolh@yahoo.com.br., Fornazari VR; Division of Interventional Neuroradiology, Department of Radiology, Hematology and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil., Nakiri GS; Division of Interventional Neuroradiology, Department of Radiology, Hematology and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil., Abud TG; Division of Interventional Neuroradiology, Department of Radiology, Hematology and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Department of Interventional Neuroradiology, Hospital Israelita Albert Einstein, São Paulo, Brazil., Monsignore LM; Division of Interventional Neuroradiology, Department of Radiology, Hematology and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil., Dias FA; Division of Neurology, Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil., Martins-Filho RK; Division of Neurology, Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil., Camilo MR; Division of Neurology, Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil., Aléssio-Alves FF; Division of Neurology, Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil., Pontes-Neto OM; Division of Neurology, Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil., Abud DG; Division of Interventional Neuroradiology, Department of Radiology, Hematology and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2021 Mar; Vol. 147, pp. e363-e372. Date of Electronic Publication: 2020 Dec 17.
DOI: 10.1016/j.wneu.2020.12.060
Abstrakt: Background: Acute basilar artery occlusion is a devastating life-threatening condition. Early recanalization is the therapeutic goal in patients with acute ischemic stroke. Despite the high rates of recanalization achieved with modern devices for basilar occlusions, many patients have had poor clinical outcomes. This study aimed to assess the predictors of good and poor outcomes among patients with basilar artery occlusion treated with thrombectomy.
Methods: A consecutive registry of 80 patients was included in this retrospective study. The primary end point was to access variables associated with neurologic outcomes defined by a modified Rankin Scale (mRS) score of 0-2, symptomatic intracranial hemorrhage (sICH), and mortality at 3 months follow-up.
Results: Recanalization was achieved in 86.2%, and the sICH rate was 8.7%. A good neurologic outcome (mRS score 0-2) was observed in 26.2% and a moderate outcome (mRS score 0-3) in 32.5% of patients. The mortality was 38.7% at 3 months follow-up.
Conclusions: After thrombectomy for posterior circulation strokes, young patients, V4-proximal basilar occlusion, (high) baseline posterior circulation Alberta Stroke Program Early CT Score, and complete recanalization were independent predictors of good neurologic outcomes. Failure to recanalize was strongly related to sICH and mortality. In addition, diabetes, atrial fibrillation, and baseline National Institutes of Health Stroke Scale scores ≥10 had an independent association with mortality. This study contributes to the knowledge required to optimize recanalization treatments for posterior circulation strokes and may help to improve future clinical studies.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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