The Role of Hyperdense Basilar Artery Sign in Predicting Outcome of Acute Basilar Artery Occlusion within Twelve Hours of Onset

The correlation between hyperdense basilar artery sign (HDBAS) and outcome after acute basilar artery occlusion (ABAO) is debated. Our objective was to determine the usefulness of HDBAS in predicting the outcomes of patients with ABAO after endovascular treatment (EVT), intravenous thrombolysis (IVT...

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Published in:	World neurosurgery Vol. 183; pp. e470 - e482
Main Authors:	Hu, Xiaohui, Su, Junfeng, Chen, Li, Li, Rui, Tao, Chunrong, Yin, Yamei, Liu, Huanhuan, Tan, Xianhong, Hou, Siyang, Xie, Sanpin, Huo, Longwen, Zhu, Yuyou, Gong, Daokai, Hu, Wei, Liu, Xinfeng, Wang, Guoping, Nogueira, Raul G., Qureshi, Adnan I., Baxter, Blaise W., Xu, Gelin, Yan, Xiaoyan, Gao, Feng, Jiao, Liqun, Qun, Sen, Wang, Zi, Chen, Juan, Ye, Ruidong, Zhang, Yongwei, Wu, Cangjun, Fang, Chuanqing, Deng, Kexue, Yuan, Shuya, Zheng, Menglong, Chen, Hongbing, Zhang, Guang, Bao, Wei, Han, Hongxing, Yuan, Guangxiong, Wen, Changming, Zhou, Peiyang, Chen, Wenhuo, Zeng, Guoyong, Xu, Hui, Li, Yuwen, Ma, Zhengfei, Yu, Chuanqing, Zhou, Zhiming, Chen, Zhongjun, Liao, Geng, Sun, Yaxuan, Ren, Youquan, Zhang, Hui, Chen, Jie, Yue, Xincan, Ma, Xiuyao, Xiao, GuoDong, Wang, Li, Liu, Rui, Yang, Weimin, Liu, Wenhua, Liu, Yong, Guo, Fuqiang, Cai, Xueli, Yin, Bo, Li, Jinglun, Fang, Pu, Shen, Chunyun, Ni, Chuyuan, Wang, Hui, Liu, Liang, Li, Kai, Cui, Tao, Wang, Hao, Gao, Jun, Yi, Tingyu, Wang, Youmeng, Wang, Tao, Shi, Xueying, Cao, Zhihua, Long, Chen, Zhang, Chi, Zhai, Gichao, Zhang, Xia, Liang, Xiushan, Li, Qingsong, Meng, Yuhan, Tao, Jianbo, Zhu, Zhenzhu, Cheng, Yuedong, Zhang, Meng, Zhou, Tong, Wang, Jing, Zhang, Yali
Format:	Journal Article
Language:	English
Published:	Elsevier Inc 01-03-2024
Subjects:	Acute basilar artery occlusion ATTENTION trial Function outcome Hyperdense basilar artery sign Thrombectomy NIHSS EVT OR ASPECTS Acute basilar artery occlusion CI IVT BMT ATTENTION trial Function outcome HMCAS MCA HDBAS mRS ABAO CT Thrombectomy BASILAR Hyperdense basilar artery sign BA
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Summary:	The correlation between hyperdense basilar artery sign (HDBAS) and outcome after acute basilar artery occlusion (ABAO) is debated. Our objective was to determine the usefulness of HDBAS in predicting the outcomes of patients with ABAO after endovascular treatment (EVT), intravenous thrombolysis (IVT), and best medical treatment (BMT). The study participants were selected from the ATTENTION trial. The primary outcome of the study was a 90-day modified Rankin Scale (mRS) score, and the secondary outcome was the recanalization rate, any intracranial hemorrhage, and 90-day mortality. The study comprised 276 participants, with cohorts for EVT (n = 188), IVT (n = 82), and BMT (n = 88). In the EVT cohort, HDBAS was not associated with 90-day mRS score (adjusted odds ratio [OR], 0.87; 95% confidence interval [CI], 0.51–1.48; P = 0.6029), the recanalization after 24 hours of onset (adjusted OR, 0.76; 95% CI, 0.30–3.61; P = 0.9422), and 90-day mortality (adjusted OR, 0.77; 95% CI, 0.41–1.46; P = 0.4238). In the IVT cohort, HDBAS was not associated with a 90-day mRS score (adjusted OR, 0.69; 95% CI, 0.31–1.56; P = 0.3742), the recanalization after 24 hours of onset (adjusted OR, 2.24; 95% CI, 0.47–10.78; P = 0.3132), and 90-day mortality (adjusted OR, 0.64; 95% CI, 0.26–1.57; P = 0.3264). Similarly, in the BMT cohort, HDBAS was not associated with 90-day mRS score (adjusted OR, 1.11; 95% CI, 0.47–2.63; P = 0.8152), the recanalization after 24 hours of onset (adjusted OR, 1.27; 95% CI, 0.40–4.02; P = 0.6874), and 90-day mortality (adjusted OR, 1.17; 95% CI, 0.46–2.96; P = 0.748). HDBAS may not be a reliable predictor of outcomes for patients with ABAO, regardless of whether they received EVT, IVT, or BMT.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1878-8750 1878-8769 1878-8769
DOI:	10.1016/j.wneu.2023.12.122