The importance of collateral circulation in acute basilar artery occlusion

Czech version

Authors: M. Tinková ¹; P. Malý ¹; H. Parobkova ²; O. Bradáč ¹
Authors‘ workplace: Ústav klinických neurooborů, Komplexní cerebrovaskulární centrum, – neurologické a neurochirurgické, oddělení, ÚVN a VFN, Praha ; Radiodiagnostické oddělení, ÚVN a VFN, Praha ²
Published in: Cesk Slov Neurol N 2019; 82(5): 518-525
Category: Original Paper
doi: https://doi.org/10.14735/amcsnn2019518

Overview

Aim: We evaluated the prognostic value of a radiological Basilar Artery on Computed Tomography Angiography (BATMAN) score in patients with acute arterial basilaris occlusion (BAO).

Methods: We retrospectively analyzed clinical and imaging data of consecutive endovascular therapy-treated patients with BAO in our stroke unit between 2006– 2018. The diagnosis of BAO was made on CTA. BATMAN score is a 10-point CTA-based grading system. Good outcome was defined as a modified Rankin Scale score of 0– 3 within 3 months.

Results: We included 67 patients (37 men) with BAO treated with endovascular therapy (mechanical thrombectomy): mean age 63 years (range 31– 82 years), median National Institutes of Health Stroke Scale (NIHSS) 16; and interquartile range 2– 36. Succesful recanalization modified as Thrombolysis in Cerebral Infarction (TICI) 2b-3 was achieved in 91% (61/ 67) of patients. Multivariate logistic regression analysis identified BATMAN score ≤ 7 (OR 27.59; 95% CI 5.78– 131.81; P = 0.001) and initial NIHSS ≥ 10 (OR 9.62; 95% CI 1.47– 63.10; P = 0.0183) as independent predictors of poor outcome.

Conclusion: The BATMAN score demonstrated its ability to predict severe disability and death after BAO despite endovascular reperfusion therapies.

Autoři deklarují, že v souvislosti s předmětem studie nemají žádné komerční zájmy.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

Redakční rada potvrzuje, že rukopis práce splnil ICMJE kritéria pro publikace zasílané do biomedicínských časopisů.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Přijato k recenzi: 19. 7. 2019

Přijato do tisku: 21. 8. 2019

侧支循环在急性基底动脉阻塞中的重要性

目的：我们评估了放射基底动脉对急性基底动脉阻塞(BAO)患者的ct血管成像(BATMAN)评分的预后价值。

方法：我们回顾性分析了2006 - 2018年期间在我们卒中单元连续进行血管内治疗的BAO患者的临床和影像学资料。BAO的诊断是在CTA上做出的。BATMAN 分数是一个基于cta的10分制评分系统。好结果定义为3个月内修改Rankin评分0 - 3分。

结果：我们纳入67例(37名男性)鲍接受血管内治疗(机械血栓切除术)的患者:平均年龄63岁(范围31 - 82岁)，中位国家卫生研究院卒中量表(NIHSS) 16;四分位数范围为2 - 36。脑梗死(TICI) 2b-3再通改良溶栓成功91%(61/ 67)。多元逻辑回归分析确定BATMAN得分≤7（OR 27.59; 95％CI 5.78– 131.81; P = 0.001）和初始NIHSS≥10（OR 9.62; 95％CI 1.47– 63.10; P = 0.0183）作为不良结果的独立预测因子。

结论：尽管进行了血管内再灌注治疗，BATMAN评分也证明了其能够预测BAO后严重残疾和死亡的能力。

关键词：基底动脉闭塞–侧支循环–血管内治疗– BATMAN评分

Keywords:

basilar artery occlusion – collateral circulation – endovascular therapy – BATMAN score

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