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Research ArticleInterventional

Predictors of Favorable Outcome after Endovascular Thrombectomy in MRI: Selected Patients with Acute Basilar Artery Occlusion

M. Mahmoudi, C. Dargazanli, F. Cagnazzo, I. Derraz, C. Arquizan, A. Wacogne, J. Labreuche, A. Bonafe, D. Sablot, P.H. Lefevre, G. Gascou, N. Gaillard, C. Scott, V. Costalat and I. Mourand
American Journal of Neuroradiology September 2020, 41 (9) 1670-1676; DOI: https://doi.org/10.3174/ajnr.A6741
M. Mahmoudi
aFrom the Neuroradiology Department (M.M., C.D., F.C., I.D., A.B., P.H.L., G.G., V.C.), Centre Hospitalier Universitaire Gui De Chauliac, Montpellier, France
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C. Dargazanli
aFrom the Neuroradiology Department (M.M., C.D., F.C., I.D., A.B., P.H.L., G.G., V.C.), Centre Hospitalier Universitaire Gui De Chauliac, Montpellier, France
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F. Cagnazzo
aFrom the Neuroradiology Department (M.M., C.D., F.C., I.D., A.B., P.H.L., G.G., V.C.), Centre Hospitalier Universitaire Gui De Chauliac, Montpellier, France
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I. Derraz
aFrom the Neuroradiology Department (M.M., C.D., F.C., I.D., A.B., P.H.L., G.G., V.C.), Centre Hospitalier Universitaire Gui De Chauliac, Montpellier, France
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C. Arquizan
bNeurology Department (C.A., N.G.), Centre Hospitalier Universitaire Gui De Chauliac, Montpellier, France
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A. Wacogne
cNeurology Department (A.W.), Centre Hospitalier Universitaire Caremeau, Nimes, France
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J. Labreuche
dBiostatistics Department (J.L.), Centre Hospitalier Universitaire Lille, Lille, France
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A. Bonafe
aFrom the Neuroradiology Department (M.M., C.D., F.C., I.D., A.B., P.H.L., G.G., V.C.), Centre Hospitalier Universitaire Gui De Chauliac, Montpellier, France
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D. Sablot
eNeurology Department (D.S.), Centre Hospitalier de Perpignan, Perpignan, France
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P.H. Lefevre
aFrom the Neuroradiology Department (M.M., C.D., F.C., I.D., A.B., P.H.L., G.G., V.C.), Centre Hospitalier Universitaire Gui De Chauliac, Montpellier, France
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G. Gascou
aFrom the Neuroradiology Department (M.M., C.D., F.C., I.D., A.B., P.H.L., G.G., V.C.), Centre Hospitalier Universitaire Gui De Chauliac, Montpellier, France
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N. Gaillard
bNeurology Department (C.A., N.G.), Centre Hospitalier Universitaire Gui De Chauliac, Montpellier, France
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C. Scott
fDepartment of Reanimation (C.S.), Centre Hospitalier Universitaire Gui De Chauliac, Montpellier, France
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V. Costalat
aFrom the Neuroradiology Department (M.M., C.D., F.C., I.D., A.B., P.H.L., G.G., V.C.), Centre Hospitalier Universitaire Gui De Chauliac, Montpellier, France
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I. Mourand
bNeurology Department (C.A., N.G.), Centre Hospitalier Universitaire Gui De Chauliac, Montpellier, France
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    On-line Fig 3.

    Functional outcomes at 90 days according to the mRS score. Distribution of 90-day mRS scores in patients with complete (mTICI 3) versus mTICI 0–2b reperfusion (A) and success of reperfusion (mTICI 2b–3) versus mTICI 0-2a (B). Scores range from 0 to 6, with higher scores indicating greater disability.

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    Table 1:

    Angiographic and clinical outcomesa

    OutcomesNo.Values
    Successful reperfusion (mTICI 2b–3)11090 (81.8)
    Complete reperfusion (mTICI 3)11067 (60.9)
    Onset to successful reperfusion (median) (IQR) (min)b90455 (340–570)
    Groin puncture to successful reperfusion (median) (IQR) (min)9045 (22–70)
    No. of passes (median) (IQR)1101 (1–2)
    Re-occlusion1106 (5.5)
    Procedural complications11020 (18.2)
        Dissectionc13 (11.8)
        Embolization8 (7.3)
        Vasospasm2 (1.8)
    Growth of infarct core11035 (31.8)
    Any ICH11013 (11.8)
    sICH1103 (2.7)
    Favorable outcome (90-day mRS 0–2)11035 (31.8)
    Poor outcome (90-day mRS 3–6)11075 (68.1)
    90-Day all-cause mortality11045 (40.9)
    • Note:—ICH indicates intracranial hemorrhage.

    • ↵a Values are No. (%) unless otherwise as indicated.

    • ↵b Data among patients with successful reperfusion.

    • ↵c Involved V1 segment (n = 1), V3 segment (n = 3), V4 segment (n = 3), and basilar artery (n = 6).

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    Table 2:

    Independent predictors of favorable outcomea

    Model 1Model 2
    OR (95% CI)POR (95% CI)P
    Pretreatment NIHSS0.77 (0.64–0.94).0070.82 (0.68–0.98).030
    PcomA collateral flow2.87 (1.05–7.84).0393.38 (1.20–8.96).021
    IV thrombolysis2.71 (1.04–7.04).040Not selected
    Atrial fibrillation0.18 (0.03–0.99).049Not selected
    Onset to groin puncture0.95 (0.89–1.01).062Not selected
    Pretreatment DWI BSS0.76 (0.54–1.06).0960.74 (0.52–1.02).069
    Complete recanalizationNot included–6.59 (2.17–20.03).001
    C-statistics (95% CI)0.803 (0.710–0.897)0.816 (0.732–0.901)
    Pseudo-R20.2480.232
    Goodness-of-fit testP = .85P = .74
    • Note:—– indicates not available.

    • ↵a ORs were calculated using a backward-stepwise multivariable penalized-likelihood logistic model. Candidate predictors in model 1 were mothership, admission to intensive care, atrial fibrillation, pretreatment NIHSS, pretreatment ASPECTS, pretreatment DWI BSS, IV thrombolysis, PcomA collateral flow, thalamus involvement, and onset-to-groin puncture time. Candidate predictors in model 2 were mothership, admission to intensive care, atrial fibrillation, pretreatment NIHSS, pretreatment PC-ASPECTS, pretreatment DWI BSS, IV thrombolysis, PcomA collateral flow, thalamus involvement, onset-to-groin puncture time, and complete recanalization (mTICI 3).

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American Journal of Neuroradiology: 41 (9)
American Journal of Neuroradiology
Vol. 41, Issue 9
1 Sep 2020
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M. Mahmoudi, C. Dargazanli, F. Cagnazzo, I. Derraz, C. Arquizan, A. Wacogne, J. Labreuche, A. Bonafe, D. Sablot, P.H. Lefevre, G. Gascou, N. Gaillard, C. Scott, V. Costalat, I. Mourand
Predictors of Favorable Outcome after Endovascular Thrombectomy in MRI: Selected Patients with Acute Basilar Artery Occlusion
American Journal of Neuroradiology Sep 2020, 41 (9) 1670-1676; DOI: 10.3174/ajnr.A6741

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Predictors of Favorable Outcome after Endovascular Thrombectomy in MRI: Selected Patients with Acute Basilar Artery Occlusion
M. Mahmoudi, C. Dargazanli, F. Cagnazzo, I. Derraz, C. Arquizan, A. Wacogne, J. Labreuche, A. Bonafe, D. Sablot, P.H. Lefevre, G. Gascou, N. Gaillard, C. Scott, V. Costalat, I. Mourand
American Journal of Neuroradiology Sep 2020, 41 (9) 1670-1676; DOI: 10.3174/ajnr.A6741
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