AUTHOR=Hu Jinrong , He Wencheng , Zheng Bo , Huang Fang , Lv Kefeng , Liao Jiasheng , Chen Zhao , Jiang He , Wang Kuiyun , Wang Hongjun , Lei Yang , Liao Jiachuan , Sang Hongfei , Liu Shuai , Luo Weidong , Sun Ruidi , Yang Jie , Huang Jiacheng , Song Jiaxing , Li Fengli , Zi Wenjie , Long Chen , Yang Qingwu 

TITLE=Hyperdense Artery Sign and Clinical Outcomes After Endovascular Treatment in Acute Basilar Artery Occlusion

JOURNAL=Frontiers in Neurology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.830705

DOI=10.3389/fneur.2022.830705

ISSN=1664-2295

ABSTRACT=Background: This study aimed to investigate the association between the hyperdense basilar artery sign (HBAS) on nonenhanced computed tomography (CT) and clinical outcomes in patients with acute basilar artery occlusion (BAO) who underwent endovascular treatment (EVT).
Methods: Eligible patients who underwent EVT due to acute BAO between January 2014 and May 2019 were divided into two groups based on HBAS. HBAS was assessed by two neuroradiologists considering five levels on nonenhanced CT. The primary outcome was a favorable functional outcome (defined as a modified Rankin Scale of 0–3) at 90 days. Secondary outcomes included successful recanalization and mortality within 90 days.
Results: Among 829 patients, 643 patients treated with EVT had CT on admission. Of these, 51.32% (330/643) had HBAS. Patients with HBAS were older and had more severe neurological deficits and a higher frequency of atrial fibrillation than those without HBAS. There was no significant difference in favorable outcome (adjusted odds ratio [aOR] 1.354, 95% CI 0.906–2.024; p=0.14), successful recanalization (aOR 0.926, 95% CI 0.616–¬1.393; p=0.71), and mortality (aOR 1.193, 95% CI 0.839–1.695; p=0.33) between patients with or without HBAS. Subgroup analysis showed that the HBAS predicted a favorable outcome in patients aged <60 years (aOR 2.574, 95% CI 1.234–5.368; p=0.01) and patients with vertebral artery-V4 segment occlusion (aOR 3.738, 95% CI 1.212–11.530; p=0.02).
Conclusions: Among patients with acute BAO, the associations of HBAS with favorable outcomes and successful recanalization after EVT was not significant. Moreover, our data indicated a possible benefit of HBAS in patient age <60 years or in VA-V4 occlusion.