학술논문
Thrombectomy for Comatose Patients with Basilar Artery Occlusion
Original Article
Original Article
Document Type
Academic Journal
Author
Source
Clinical Neuroradiology. December 2021, Vol. 31 Issue 4, p1131, 10 p.
Subject
Language
English
ISSN
1869-1439
Abstract
Author(s): Adrien Guenego [sup.1] [sup.2], Ludovic Lucas [sup.3], Benjamin Gory [sup.4] [sup.5] [sup.6], Sébastien Richard [sup.6] [sup.7], Mathilde Aubertin [sup.1], David Weisenburger-Lile [sup.8], Julien Labreuche [sup.9], Cyril Dargazanli [sup.10], Amel [...]
Purpose Acute ischemic stroke (AIS) secondary to a basilar artery occlusion (BAO) carries a poor prognosis, especially in cases of severe symptoms, such as coma at presentation. Despite a lack of evidence, mechanical thrombectomy (MT) is often performed as the procedural risks are felt to be minimal compared to the natural history. We sought to evaluate MT efficacy and safety in comatose BAO patients. Methods We performed a retrospective analysis of a multicenter prospective cohort of consecutive AIS patients with BAO who underwent MT. We compared baseline characteristics between comatose and noncomatose BAO patients, as well as clinical outcomes (modified Rankin scale, mRS 0-3â¯at 3 months). Using a multivariate logistic regression, we examined the population of comatose patients for baseline predictive factors of mortality. Results We included 269 patients, 72 (27%) comatose and 197 (73%) non-comatose. Despite similar recanalization rates between comatose and non-comatose patients (83% vs. 90% pâ¯= 0.221), comatose patient long-term outcomes were dramatically worse (11% mRS 0-3 vs. 54%, p⯠Conclusion Thrombectomy is technically effective for BAO patients presenting with coma; however, the long-term favorable outcome remains poor. Male sex, old age and hyperglycemia were predictors of mortality in these patients.
Purpose Acute ischemic stroke (AIS) secondary to a basilar artery occlusion (BAO) carries a poor prognosis, especially in cases of severe symptoms, such as coma at presentation. Despite a lack of evidence, mechanical thrombectomy (MT) is often performed as the procedural risks are felt to be minimal compared to the natural history. We sought to evaluate MT efficacy and safety in comatose BAO patients. Methods We performed a retrospective analysis of a multicenter prospective cohort of consecutive AIS patients with BAO who underwent MT. We compared baseline characteristics between comatose and noncomatose BAO patients, as well as clinical outcomes (modified Rankin scale, mRS 0-3â¯at 3 months). Using a multivariate logistic regression, we examined the population of comatose patients for baseline predictive factors of mortality. Results We included 269 patients, 72 (27%) comatose and 197 (73%) non-comatose. Despite similar recanalization rates between comatose and non-comatose patients (83% vs. 90% pâ¯= 0.221), comatose patient long-term outcomes were dramatically worse (11% mRS 0-3 vs. 54%, p⯠Conclusion Thrombectomy is technically effective for BAO patients presenting with coma; however, the long-term favorable outcome remains poor. Male sex, old age and hyperglycemia were predictors of mortality in these patients.