Article Figures & Data
Figures
- Fig 1.
Prethrombectomy DWI (A) of a 54-year-old woman with tetraplegia in a coma. The DWI shows extensive bilateral lesions in the pons and limited bilateral lesions in the midbrain (brain stem score, 2 + 2 +1 + 1 = 6). DSA shows a midbasilar occlusion (B) successfully recanalized after IV thrombolysis and a thrombectomy (TICI 3). Time from symptom onset to recanalization was 283 minutes (4 hours 43 minutes). The outcome was unfavorable by day 180 (mRS 5).
- Fig 2.
An 88-year-old woman who had right hemiparesis, vertigo, dysarthria, and vomiting. Pretreatment DWI (A) shows an extensive lesion in the left pons (brain stem score, 2) with a distal basilar clot on DSA (B) recanalized after IV thrombolysis and a thrombectomy (TICI 3). The time from symptom onset to recanalization was 336 minutes (4 hours 63 minutes). At day 180, the outcome was favorable (mRS 0).
Tables
Clinical Characteristics Radiologic Characteristics (No.) (%) Mean age (yr) 61 ± 17 Site of basilar artery occlusion Men (No.) (%) 15 (48) Proximal 4 (13) Median NIHSSa (IQR) 38 (9–38) Mid 8 (26%) Median Glasgow Coma Scalea (IQR) 7 (4–14) Distal 19 (61%) Tetraplegia (No.) (%) 11 (35.5) Presence of collateral flow 19 (61) Coma (GCS ≤8) (No.) (%) 19 (61) Cardioembolic infarct (No.) (%) 16 (52) Note:—GCS indicates Glasgow Coma Scale.
↵a Prethrombectomy.
- Table 2:
Outcome characteristics (recanalization rate, procedural complications, and clinical outcome) of 31 patients
Recanalization rate (TICI 3–2b) 23 (74%) Clinical outcome ≥180 days Median NIHSS (IQR) 3 (2–6) Procedural complications Median Barthel Index (IQR) 100 (45–100) New embolic infarcts 10 (32%) Median mRS (IQR) 4 (2–6) Intracranial hemorrhage symptomatic 5 (16%) mRS 0–2 11 (35%) mRS 3–5 10 (32%) Other 0 mRS 6 10 (32%) Scores AUC (95% CI) Cutoff Sensitivity Specificity PPV NPV Favorable outcome (mRS ≤2) DWI BSS 0.76 (0.58–0.95 <3 64% 85% 70% 81% pc-ASPECTS 0.63 (0.41–0.84) ≥7 55% 65% 46% 72% Renard et al15 0.73 (0.53–0.92 <3.5 82% 65% 56% 87% Very poor outcome (mRS ≥5) DWI BSS 0.80 (0.63–0.96) ≥2 100% 41% 58% 100% ≥3 93% 53% 62% 90% ≥4 79% 65% 65% 79% ≥5 29% 94% 80% 62% ≥6 21% 100% 100% 61% Note:—NPV indicates negative predictive value.
- Table 5:
Predictors of favorable outcome (mRS ≤2) analyzed by univariate regression logistic
OR 95% CI P Value Age (yr) 0.96 0.91–1.01 .08 DWI BSS <3 9.92 1.75–56.30 .01 pc-ASPECTS ≥7 2.23 0.50–10.00 .30 Renard et al15 <3.5 8.36 1.40–49.88 .02
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