Transverse diameter of brainstem infarction is a strong predictor of miserable outcome after mechanical thrombectomy for acute basilar artery occlusion.

Autor: Tajima Y; Department of Neurological Surgery, Chiba University Hospital, 1-8-1 Inohana, Chiba, 260-8677, Japan. tajima5615@yahoo.co.jp., Yoshida Y; Department of Neurological Surgery, Chiba University Hospital, 1-8-1 Inohana, Chiba, 260-8677, Japan., Kubota M; Department of Neurological Surgery, Chiba University Hospital, 1-8-1 Inohana, Chiba, 260-8677, Japan., Ebihara K; Department of Neurosurgery, Kimitsu Chuo Hospital, 1010 Sakurai, Kisarazu, 292-8535, Japan., Yamauchi T; Department of Neurosurgery, Chiba Emergency and Psychiatric Medical Center, 6-1 Toyosuna, Chiba, 261-0012, Japan., Nishino W; Department of Neurosurgery, Chiba Emergency and Psychiatric Medical Center, 6-1 Toyosuna, Chiba, 261-0012, Japan., Niimi J; Department of Neurosurgery, Funabashi Municipal Medical Center, 1-21-1 Kanasugi, Funabashi, 273-8588, Japan., Nakamura K; Department of Neurosurgery, Chiba Neurosurgical Clinic, 408 Naganumahara, Chiba, 263-0001, Japan., Kado K; Department of Neurosurgery, Chiba Medical Center, 1-7-1 Minami-cho, Chiba, 260-0842, Japan., Miyazaki T; Department of Neurosurgery, Japan Red Cross Narita Hospital, 90-1, Iida-cho, Narita, Chiba, 286-8523, Japan., Watanabe Y; Department of Neurosurgery, Matsudo City General Hospital, 993-1 Sendabori, Matsudo, Chiba, 270-2296, Japan., Mochida H; Department of Neurosurgery, Asahi General Hospital, Asahi, I-1326289-2511, Japan., Oishi H; Department of Neurosurgery, Eastern Chiba Medical Center, 3-6-2 Okayamadai, Togane, 283-8686, Japan., Higuchi Y; Department of Neurological Surgery, Chiba University Hospital, 1-8-1 Inohana, Chiba, 260-8677, Japan.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 Aug 06; Vol. 14 (1), pp. 18201. Date of Electronic Publication: 2024 Aug 06.
DOI: 10.1038/s41598-024-68865-y
Abstrakt: Although the efficacy of mechanical thrombectomy (MT) for acute basilar artery occlusion (ABAO) has been established in two randomized controlled studies, many patients have miserable clinical outcomes after MT for ABAO. Predicting severe disability prior to the procedure might be useful in determining the appropriateness of treatment interventions. Among the ABAO cases treated at 10 hospitals between July 2014 and December 2021, 144 were included in the study, all of whom underwent MRI before treatment. A miserable outcome was defined as a modified Rankin Scale (mRS) of 5-6 at 3 months. The associations between clinical, imaging, and procedural factors and miserable outcomes were evaluated. A miserable outcome was observed in 54 cases (37.5%). Multivariate analysis identified the National Institutes of Health Stroke Scale (NIHSS), transverse diameter of brainstem infarction, and symptomatic intracerebral hemorrhage as independent factors associated with miserable outcomes, with cutoff values of NIHSS 22 and transverse diameter of brainstem infarction 15 mm. Cases with a higher preoperative severity may result in miserable postoperative outcomes. Particularly, the transverse diameter of a brainstem infarction can be easily measured and serves as a useful criterion for determining treatment indications.
(© 2024. The Author(s).)
Databáze: MEDLINE
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