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Basilar tip morphology: impact on mechanical thrombectomy for acute distal basilar artery occlusion

Authors
 Sung Hyun Baik  ;  Cheolkyu Jung  ;  Byung Moon Kim  ;  Dong Joon Kim 
Citation
 JOURNAL OF NEUROINTERVENTIONAL SURGERY, Vol.15(e3) : e396-e401, 2023-12 
Journal Title
JOURNAL OF NEUROINTERVENTIONAL SURGERY
ISSN
 1759-8478 
Issue Date
2023-12
MeSH
Arterial Occlusive Diseases* / diagnostic imaging ; Arterial Occlusive Diseases* / surgery ; Basilar Artery / diagnostic imaging ; Basilar Artery / surgery ; Cerebral Angiography ; Endovascular Procedures* ; Humans ; Retrospective Studies ; Stroke* ; Thrombectomy ; Treatment Outcome
Keywords
angiography ; brain ; stroke ; thrombectomy
Abstract
Background: The morphology of the basilar artery tip (BAT) varies between patients. The morphologic anatomy of the BAT could affect the efficacy of mechanical thrombectomy (MT).

Methods: 108 patients with acute distal basilar artery occlusion (dBAO) who underwent MT from January 2013 to December 2021 were retrospectively analyzed. These patients were divided into two groups based on their BAT morphology: those with symmetrical cranial or caudal fusion of the BAT (symmetric group) and those with asymmetrical fusion of the BAT (asymmetric group). Morphological variables and angiographic and clinical outcomes were compared between the two groups.

Results: Of the 108 enrolled patients, 42 were in the asymmetric group. Compared with the symmetric group, the asymmetric group had significantly larger BAT diameter (mean 3.5±1.0 mm vs 4.3±1.1 mm, P=0.001) and basilar artery tip/trunk ratio (1.2±0.2 vs 1.7±0.2, P<0.001). The asymmetric group showed a significantly lower rate of complete reperfusion (71.2% vs 40.5%, P=0.002) and first pass effect (FPE) (51.5% vs 21.4%, P=0.002) than the symmetric group. The BAT asymmetry was an independent predictor of failed FPE (OR 0.299, 95% CI 0.098 to 0.918, P=0.035) and failed complete reperfusion (OR 0.275, 95% CI 0.087 to 0.873, P=0.029).

Conclusions: The efficacy of MT for dBAO differs according to the anatomic morphology of the BAT. The asymmetric BAT was frequently encountered in dBAO patients and was independently associated with a reduced likelihood of complete reperfusion and FPE.
Full Text
https://jnis.bmj.com/content/15/e3/e396.long
DOI
10.1136/jnis-2022-019841
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Kim, Byung Moon(김병문) ORCID logo https://orcid.org/0000-0001-8593-6841
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/197811
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