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Updated: Jul 29, 2026
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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
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Predictors of devastating functional outcome despite successful basilar thrombectomy
Rahul R Karamchandani1, Sagar Satyanarayana2, Hongmei Yang2
1Department of Neurology, Neurosciences Institute, Atrium Health, Charlotte, NC, USA.
Summary
Severe stroke, low glucose, and proximal basilar occlusion predict poor outcomes in basilar thrombectomy patients. These factors aid in medical decisions and clinical trial patient selection for better results.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Stroke Medicine
Background:
- Basilar artery thrombosis often results in severe disability or death, despite successful endovascular reperfusion.
- Identifying predictors of poor outcomes is crucial for optimizing treatment strategies in basilar artery occlusion.
Purpose of the Study:
- To investigate factors associated with devastating functional outcomes (90-day modified Rankin Scale [mRS] score 5-6) in patients undergoing basilar thrombectomy with successful revascularization.
Main Methods:
- Retrospective analysis of a health system's stroke registry data from January 2017 to May 2023.
- Inclusion of patients with successful basilar thrombectomy and pretreatment computed tomography perfusion evaluation.
- Multivariable logistic regression to identify independent predictors of poor functional outcome (mRS 5-6).
Main Results:
- Of 64 patients, 43.8% experienced devastating functional outcomes.
- Presenting National Institutes of Health Stroke Scale (NIHSS) score (OR 1.08), initial glucose level (OR 0.99), and proximal occlusion site (OR 7.38) were independently associated with poor outcomes.
- The multivariable model demonstrated strong predictive ability with an area under the receiver operator characteristics curve (AUC) of 0.81.
Conclusions:
- Presenting stroke severity, lower initial glucose levels, and proximal basilar occlusion are significant predictors of poor neurological outcomes after successful basilar thrombectomy.
- These identified factors can inform clinical decision-making and aid in patient selection for future clinical trials aimed at improving outcomes in basilar artery occlusion.
