AUTHOR=Ryu Jae-Chan , Kwon Boseong , Song Yunsun , Lee Deok Hee , Chang Jun Young , Kang Dong-Wha , Kwon Sun U. , Kim Jong S. , Kim Bum Joon 

TITLE=Delayed low cerebellar perfusion status is associated with poor outcomes in top-of-basilar occlusion treated with thrombectomy

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1161198

DOI=10.3389/fneur.2023.1161198

ISSN=1664-2295

ABSTRACT=Background and purpose: Top-of-basilar artery occlusion (TOB) is one of the most devastating stroke despite the successful mechanical thrombectomy (MT). We aimed to investigate the impact of initial low cerebellum perfusion delay on the outcomes of TOB treated with MT.
Methods: We included patients who underwent MT for TOB. Clinical and peri-procedural variables were obtained. Perfusion delay in the low cerebellum was defined as 1) time-to-maximum (Tmax) >10s lesion or 2) relative time-to-peak (rTTP) map >9.5s with a diameter of ≥6 mm in the low cerebellum. The good functional outcome was defined as the achievement of a modified Rankin Scale score of 0–3 at 3 months after stroke.
Results: Among the 42 included patients, 24 (57.1%) patients showed perfusion delay in the low cerebellum. Admission National Institutes of Health Stroke Scale (NIHSS) score was significantly higher in those with perfusion delay (17 [12-24] vs. 8 [6-15], P=0.002). Accordingly, the proportion of good functional outcomes was lower in those with perfusion delay than in those without (5 [20.8%] vs. 13 [72.2%], P=0.003). From the multivariable analysis, the admission NIHSS score (odds ratio [OR]=0.86, 95% confidence intervals [CIs]=0.75–0.98, P=0.021) and low cerebellum perfusion delay (OR=0.18, 95% CIs=0.04–0.86, P=0.031) were independently associated with the 3-month functional outcome.
Conclusions: We found that initial perfusion delay proximal to TOB in the low cerebellum might be a predictor for poor functional outcomes in TOB treated with MT.