Related Experiment Video
Updated: Aug 9, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Predictors of delayed reocclusion after successful recanalization in acute basilar artery occlusion patients
Xuan Sun1, Huijun Zhang2, Qiting Zhang2
1Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, China.
Insights
Delayed reocclusion after basilar artery occlusion treatment is rare but linked to poor outcomes. Patients without successful reperfusion or stent-retriever use face higher risks.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Vascular Neurology
Background:
- Delayed reocclusion (DR) following successful recanalization in acute basilar artery occlusion (BAO) is a significant concern.
- DR is associated with clinical deterioration and poor patient outcomes.
- Limited research exists on predicting DR after endovascular therapy for acute BAO.
Purpose of the Study:
- To identify predictors of delayed reocclusion (DR) after successful endovascular treatment (EVT) in patients with acute basilar artery occlusion (BAO).
- To evaluate the clinical impact of DR on patient outcomes.
Main Methods:
- A retrospective analysis of 187 patients with acute BAO undergoing EVT from 2012 to 2018.
- Reocclusion was assessed using CTA or MRA within 7 days post-thrombectomy.
- Multivariable logistic regression was employed to determine associated factors and clinical impact.
Main Results:
- Delayed reocclusion (DR) occurred in 10.1% of successfully reperfused patients.
- Patients with DR showed higher rates of intracranial atherosclerotic stenosis (ICAS) and intracranial angioplasty.
- Lower rates of stent-retriever use and modified Thrombolysis In Cerebral Infarction (mTICI) 3 reperfusion were observed in patients with DR.
- Predictors for DR included lack of mTICI 3 reperfusion and absence of stent-retriever use.
- DR was an independent predictor of unfavorable 90-day outcomes.
Conclusions:
- Delayed reocclusion (DR) after mechanical thrombectomy for acute basilar artery occlusion (BAO) is infrequent but significantly impacts outcomes.
- Patients who do not achieve mTICI 3 reperfusion or do not have stent-retriever use are at elevated risk for DR.
- Identifying these risk factors can guide preventative strategies to improve outcomes in BAO patients.
Background:
Delayed reocclusion (DR) after successful recanalization in acute basilar artery occlusion (BAO) patients, which is associated with clinical deterioration and poor outcome, has not been well studied. The current study is aimed to predict DR after successful endovascular therapy in acute BAO patients.
Method:
187 consecutive patients presenting with acute BAO and undergoing endovascular treatment (EVT) were selected in Beijing Tiantan Hospital from January 2012 to July 2018. Computed tomographic angiography (CTA) or magnetic resonance angiography (MRA) within 7 days of the thrombectomy was used to identify reocclusion of the target vessel. Multivariable logistic regression analysis was used to evaluate associated factors and clinical impact.
Results:
DR was observed in 17 of 169 successfully reperfused patients (10.1%). Patients with DR had higher frequency of intracranial atherosclerotic stenosis (ICAS) (94.1% vs. 61.8%; P = 0.01), higher frequency of intracranial angioplasty during EVT (88.2% vs. 57.2%; P = 0.02), lower frequency of stent-retriever use during EVT (52.9% vs. 78.9%; P = 0.03) and a lower proportion of modified Thrombolysis In Cerebral Infarction (mTICI) 3 reperfusion (41.2% vs. 78.3%; P < 0.01). Suggestive predictors were mTICI3 reperfusion (aOR, 0.205; 95% CI, 0.061-0.686) and stent-retriever using (aOR, 0.29; 95% CI, 0.086-0.980). DR was an independent predictor of unfavorable outcome at 90 days (aOR for mTICI ≤3, 5.205; 95% CI, 1.129-24.005).
Conclusions:
DR within 7 days after successful mechanical thrombectomy in acute BAO patients is rare but associated with poor outcome. Patients without mTICI3 reperfusion and stent-retriever using are at high risk for DR.
