Clinical evaluation of mechanical thrombectomy for patients with posterior circulation occlusion : A retrospective study
Copyright © 2024 Elsevier B.V. All rights reserved..
OBJECTIVE: Although consensus has been reached regarding the use of mechanical thrombectomy for acute large anterior circulation occlusion, its effectiveness in patients with posterior circulation occlusion remains unclear. This study aimed to establish the determining factors for good clinical outcomes of mechanical thrombectomy for posterior circulation occlusion.
METHODS: We extracted cases of acute large vessel occlusion (LVO) in the posterior circulation from a database comprising 536 patients who underwent mechanical thrombectomy at our hospital between April 2015 and March 2021.
RESULTS: Fifty-two patients who underwent mechanical thrombectomy for LVO in the posterior circulation were identified. Five patients with simultaneous occlusion of the anterior and posterior circulation were excluded; finally, 47 patients were included in this study. The median patient age was 78 years, and 36% of the patients were women. The median National Institutes of Health Stroke Scale (NIHSS) score on admission was 31, the median posterior circulation-Alberta Stroke Program Early Computed Tomography Score (pc-ASPECTS) was 8, and the median Basilar Artery on Computed Tomography Angiography (BATMAN) score was 6. The rate of good recanalization (Thrombolysis in Cerebral Infarction scale grades 2b and 3) was 96%, and a good prognosis (modified Rankin Scale score of 0-2 at 90 days) was achieved in 19 patients (40%). The median pc-ASPECTS was significantly higher in the good prognosis group than in the poor prognosis group (10 vs. 7; p = 0.007). The median NIHSS score at presentation was significantly lower in the good prognosis group than in the poor prognosis group (17 vs. 34; p = 0.02). The median BATMAN score was significantly higher in the good prognosis group than in the poor prognosis group (8 vs. 3.5; p = 0.0002). Multivariate analysis showed that an NIHSS score ≦ 20 at presentation was the only independent factor for good prognoses.
CONCLUSION: The prognosis of mechanical thrombectomy for posterior circulation LVO was better in patients with lower NIHSS scores at presentation.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:237 |
|---|---|
| Enthalten in: |
Clinical neurology and neurosurgery - 237(2024) vom: 01. Feb., Seite 108133 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Takano, Yuki [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Basilar artery computed tomography angiography score |
|---|
| Anmerkungen: |
Date Completed 04.03.2024 Date Revised 04.03.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.clineuro.2024.108133 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM368299449 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM368299449 | ||
| 003 | DE-627 | ||
| 005 | 20240304232458.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240211s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.clineuro.2024.108133 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1316.xml |
| 035 | |a (DE-627)NLM368299449 | ||
| 035 | |a (NLM)38340428 | ||
| 035 | |a (PII)S0303-8467(24)00020-9 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Takano, Yuki |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Clinical evaluation of mechanical thrombectomy for patients with posterior circulation occlusion |b A retrospective study |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 04.03.2024 | ||
| 500 | |a Date Revised 04.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2024 Elsevier B.V. All rights reserved. | ||
| 520 | |a OBJECTIVE: Although consensus has been reached regarding the use of mechanical thrombectomy for acute large anterior circulation occlusion, its effectiveness in patients with posterior circulation occlusion remains unclear. This study aimed to establish the determining factors for good clinical outcomes of mechanical thrombectomy for posterior circulation occlusion | ||
| 520 | |a METHODS: We extracted cases of acute large vessel occlusion (LVO) in the posterior circulation from a database comprising 536 patients who underwent mechanical thrombectomy at our hospital between April 2015 and March 2021 | ||
| 520 | |a RESULTS: Fifty-two patients who underwent mechanical thrombectomy for LVO in the posterior circulation were identified. Five patients with simultaneous occlusion of the anterior and posterior circulation were excluded; finally, 47 patients were included in this study. The median patient age was 78 years, and 36% of the patients were women. The median National Institutes of Health Stroke Scale (NIHSS) score on admission was 31, the median posterior circulation-Alberta Stroke Program Early Computed Tomography Score (pc-ASPECTS) was 8, and the median Basilar Artery on Computed Tomography Angiography (BATMAN) score was 6. The rate of good recanalization (Thrombolysis in Cerebral Infarction scale grades 2b and 3) was 96%, and a good prognosis (modified Rankin Scale score of 0-2 at 90 days) was achieved in 19 patients (40%). The median pc-ASPECTS was significantly higher in the good prognosis group than in the poor prognosis group (10 vs. 7; p = 0.007). The median NIHSS score at presentation was significantly lower in the good prognosis group than in the poor prognosis group (17 vs. 34; p = 0.02). The median BATMAN score was significantly higher in the good prognosis group than in the poor prognosis group (8 vs. 3.5; p = 0.0002). Multivariate analysis showed that an NIHSS score ≦ 20 at presentation was the only independent factor for good prognoses | ||
| 520 | |a CONCLUSION: The prognosis of mechanical thrombectomy for posterior circulation LVO was better in patients with lower NIHSS scores at presentation | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Basilar artery computed tomography angiography score | |
| 650 | 4 | |a Collateral circulation | |
| 650 | 4 | |a Mechanical thrombectomy | |
| 650 | 4 | |a Pc-ASPECTS | |
| 650 | 4 | |a Posterior circulation occlusion | |
| 700 | 1 | |a Koyanagi, Masaomi |e verfasserin |4 aut | |
| 700 | 1 | |a Takamatsu, Takateru |e verfasserin |4 aut | |
| 700 | 1 | |a Tokuda, Masanori |e verfasserin |4 aut | |
| 700 | 1 | |a Tomita, Hikari |e verfasserin |4 aut | |
| 700 | 1 | |a Yoshimoto, Mai |e verfasserin |4 aut | |
| 700 | 1 | |a Sakisuka, Ryo |e verfasserin |4 aut | |
| 700 | 1 | |a Kawade, Satohiro |e verfasserin |4 aut | |
| 700 | 1 | |a Naramoto, Yuji |e verfasserin |4 aut | |
| 700 | 1 | |a Nishii, Rikuo |e verfasserin |4 aut | |
| 700 | 1 | |a Yamamoto, Yasuhiro |e verfasserin |4 aut | |
| 700 | 1 | |a Nakajima, Kota |e verfasserin |4 aut | |
| 700 | 1 | |a Teranishi, Kunimasa |e verfasserin |4 aut | |
| 700 | 1 | |a Fukui, Nobuyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Sunohara, Tadashi |e verfasserin |4 aut | |
| 700 | 1 | |a Fukumitsu, Ryu |e verfasserin |4 aut | |
| 700 | 1 | |a Takeda, Junichi |e verfasserin |4 aut | |
| 700 | 1 | |a Ohara, Nobuyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Goto, Masanori |e verfasserin |4 aut | |
| 700 | 1 | |a Imamura, Hirotoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Sakai, Nobuyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Ohta, Tsuyoshi |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Clinical neurology and neurosurgery |d 1993 |g 237(2024) vom: 01. Feb., Seite 108133 |w (DE-627)NLM000340820 |x 1872-6968 |7 nnns |
| 773 | 1 | 8 | |g volume:237 |g year:2024 |g day:01 |g month:02 |g pages:108133 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.clineuro.2024.108133 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 237 |j 2024 |b 01 |c 02 |h 108133 | ||