Gory B, et al. - The intent of the authors was to contemplate the parameters related to the 90-day mortality in stroke patients with acute basilar artery occlusion (BAO) after modern endovascular thrombectomy (MET). It was discovered that the failure of successful recanalization served as a strong predictor of mortality. Furthermore, the additional independent predictors of mortality were age, admission National Institute of Health Stroke Scale (NIHSS), posterior circulation-Alberta Stroke Program Early CT Score (pc-ASPECTS), absence of intravenous thrombolysis, and angioplasty/stenting of the basilar artery in the setting of recanalization, after MET of BAO patients

Methods

• The enrollment consisted of 117 consecutive BAO patients.
• The candidates belonged to the Endovascular Treatment in Ischemic Stroke prospective clinical registry of consecutive acute ischemic stroke patients treated with MET (60 patients [51.3%] treated with a stent retriever as first-line technique) between March 2010 and April 2017.
• Herein, successful recanalization was defined as modified thrombolysis in cerebral infarction scores 2b-3 at the end of MET.
• Mortality was defined as modified Rankin Scale 6 at 90 days.
• Using univariate and multivariate analyses, experts gauged the correlations betwen baseline characteristics (patient and treatment characteristics) and intermediate outcomes (recanalization, complications) with 90-day mortality.

Results

• It was determined that the overall successful recanalization rate was 79.5.
• Death was reported in 41.9% (95% CI 32.8-51.0%) of patients within 90 days after MET.
• Findings shed light on a lower mortality rate (32.9 vs. 74.4%; p < 0.001) among patients with successful recanalization.
• Failure of successful recanalization was revealed to be an independent predictor of mortality (OR 5.1; 95% CI 1.34-19.33).
• As illustrated by the multivariate analysis, the following served as independent predictors for mortality after MET: Age ≥60 years (OR 6.37; 95% CI 1.74-23.31), admission National Institute of Health Stroke Scale (NIHSS) ≥13 (OR 4.62; 95% CI 1.42-15.03), lower posterior circulation-Alberta Stroke Program Early CT Score (pc-ASPECTS; OR 1.71; 95% CI 1.19-2.44), use of antithrombotic medication prior to stroke onset (OR 3.38; 95% CI 1.03-11.08), absence of intravenous thrombolysis (OR 3.36; 95% CI 1.12-10.03), and angioplasty/stenting of the basilar artery (OR 4.71; 95% CI 1.34-16.54).