AUTHOR=Xu Wei , Bao Xiang , Jiang Fengfeng , Chen Feng , Liu Boxiao , Yu Fengdan , He Pingyou 

TITLE=Factors influencing the prognosis of acute basilar artery occlusion patients treated endovascularly: the impact of treatment time window and preoperative symptoms

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1167442

DOI=10.3389/fneur.2023.1167442

ISSN=1664-2295

ABSTRACT=Objective: The aim of this study is to scrutinize the factors influencing the prognosis of patients diagnosed with acute basilar artery occlusion (BAO) , who received endovascular treatment. Our particular emphasis is on the predictive implications of the time window (from symptom onset to femoral artery puncture) and preoperative symptoms on prognosis. Methods: A retrospective analysis was undertaken of data collected from 51 BAO patients who received endovascular treatment at the Neurosurgery Department of Jinhua Central Hospital, from April 2018 to October 2021. 
The data included immediate post-interventional recanalization rates and the 90-day clinical prognoses of the patients. We used the Modified Rankin Scale (mRs) to categorize patients into two prognosis groups: a favorable prognosis group (mRs score ≤2), and an unfavorable prognosis group (mRs score >2). Preoperative symptoms were gauged using the Glasgow Coma Scale (GCS) and the National Institutes of Health Stroke Scale (NIHSS) scores. Logistic regression analysis was applied to ascertain the risk factors affecting the prognosis of endovascular treatment in BAO patients. Results: The procedure resulted in complete recanalization in all patients (100%). However, 4 patients (7.8%) passed away during the postoperative hospitalization period. A 3-month follow-up was conducted on the remaining 47 patients. It was found that 15 patients (31.91%) had a favorable prognosis, while 32 patients (68.09%) had an unfavorable prognosis. It was generally observed that patients with an unfavorable prognosis had notably higher preoperative GCS and NIHSS scores (p<0.05). Logistic regression analysis revealed that preoperative symptom severity, as indicated by the NIHSS score, and a shorter time window were significant prognostic risk factors for patients undergoing endovascular treatment for BAO (P<0.05). Conclusion: Endovascular intervention for BAO appears to be safe and effective, with a greater likelihood of a favorable prognosis in patients having a time window of ≤6 hours. This favorable prognosis could potentially be linked to the severity of the patient's preoperative symptoms.