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- Title
Predictive value of DWI posterior-circulation lesion volume for 90-day clinical outcome after endovascular treatment of acute basilar artery occlusion: a retrospective single-center study.
- Authors
Mourand, Isabelle; Mahmoudi, Mehdi; Lebars, Emmanuelle; Pavillard, Frederique; Dargazanli, Cyril; Labreuche, Julien; Gaillard, Nicolas; Ter Schiphorst, Adrien; Derraz, Imad; Sablot, Denis; Corti, Lucas; Costalat, Vincent; Arquizan, Caroline; Cagnazzo, Federico
- Abstract
Purpose: The relationship between posterior-circulation lesion volume (PCLV) and clinical outcomes is poorly investigated. We aimed to analyze, in patients with acute basilar artery occlusion (ABAO), if pre-endovascular treatment (EVT) PCLV was a predictor of outcomes. Methods: We analyzed consecutive MRI selected, endovascularly treated ABAO patients. Baseline PCLV was measured in milliliters on apparent diffusion-coefficient map reconstruction. Univariable and multivariable logistic models were used to test if PCLV was a predictor of 90-day outcomes. After the received operating characteristic (ROC) analysis, the optimal cut-off was determined to evaluate the prognostic value of PCLV. Results: A total of 110 ABAO patients were included. The median PCLV was 4.4 ml (interquartile range, 1.3–21.2 ml). Successful reperfusion was achieved in 81.8% of cases after EVT. At 90 days, 31.8% of patients had a modified Rankin scale ≤ 2, and the mortality rate was 40.9%. PCLV was an independent predictor of functional independence and mortality (odds ratio [OR]:0.57, 95% confidence interval [CI], 0.34–0.93 and 1.84, 95% CI, 1.23–2.76, respectively). The ROC analysis showed that a baseline PCLV ≤ 8.7 ml was the optimal cut-off to predict the 90-day functional independence (area under the curve [AUC] = 0.68, 95% CI, 0.57–0.79, sensitivity 88.6%, and specificity 49.3%). In addition, a PCLV ≥ 9.1 ml was the optimal cut-off for the prediction of 90-day mortality (AUC = 0.71, 95% CI, 0.61–0.82, sensitivity 80%, and specificity 60%). Conclusions: Pre-treatment PCLV was an independent predictor of 90-day outcomes in ABAO. A PCLV ≤ 8.7 and ≥ 9.1 ml may identify patients with a higher possibility to achieve independence and a higher risk of death at 90 days, respectively.
- Subjects
TIME; MAGNETIC resonance imaging; RETROSPECTIVE studies; BASILAR artery; TREATMENT effectiveness; BLOOD circulation; VASCULAR diseases; ENDOVASCULAR surgery; REPERFUSION
- Publication
Neuroradiology, 2022, Vol 64, Issue 6, p1231
- ISSN
0028-3940
- Publication type
Article
- DOI
10.1007/s00234-021-02849-x