Delayed low cerebellar perfusion status is associated with poor outcomes in top-of-basilar occlusion treated with thrombectomy
Background and purposeTop-of-basilar artery occlusion (TOB) is one of the most devastating strokes despite successful mechanical thrombectomy (MT). We aimed to investigate the impact of initial low cerebellum perfusion delay on the outcomes of TOB treated with MT.MethodsWe included patients who unde...
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1161198/full |
| _version_ | 1797840018987810816 |
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| author | Jae-Chan Ryu Boseong Kwon Yunsun Song Deok Hee Lee Jun Young Chang Dong-Wha Kang Sun U. Kwon Jong S. Kim Bum Joon Kim |
| author_facet | Jae-Chan Ryu Boseong Kwon Yunsun Song Deok Hee Lee Jun Young Chang Dong-Wha Kang Sun U. Kwon Jong S. Kim Bum Joon Kim |
| author_sort | Jae-Chan Ryu |
| collection | DOAJ |
| description | Background and purposeTop-of-basilar artery occlusion (TOB) is one of the most devastating strokes despite successful mechanical thrombectomy (MT). We aimed to investigate the impact of initial low cerebellum perfusion delay on the outcomes of TOB treated with MT.MethodsWe included patients who underwent MT for TOB. Clinical and peri-procedural variables were obtained. Perfusion delay in the low cerebellum was defined as (1) time-to-maximum (Tmax) >10 s lesions or (2) relative time-to-peak (rTTP) map >9.5 s with a diameter of ≥6 mm in the low cerebellum. The good functional outcome was defined as the achievement of a modified Rankin Scale score of 0–3 at 3 months after stroke.ResultsAmong the 42 included patients, 24 (57.1%) patients showed perfusion delay in the low cerebellum. The admission National Institutes of Health Stroke Scale (NIHSS) score was significantly higher in those with perfusion delay [17 (12–24) vs. 8 (6–15), P = 0.002]. Accordingly, the proportion of good functional outcomes was lower in those with perfusion delay than in those without [5 (20.8%) vs. 13 (72.2%), P = 0.003]. From the multivariable analysis, the admission NIHSS score [odds ratio (OR) = 0.86, 95% confidence intervals (CIs) = 0.75–0.98, P = 0.021] and low cerebellum perfusion delay (OR = 0.18, 95% Cis = 0.04–0.86, P = 0.031) were independently associated with the 3-month functional outcomes.ConclusionWe found that initial perfusion delay proximal to TOB in the low cerebellum might be a predictor for poor functional outcomes in TOB treated with MT. |
| first_indexed | 2024-04-09T16:07:38Z |
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| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-09T16:07:38Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-8b97bbcbc3b34e8e90464f3e945c7c8d2023-04-25T04:32:34ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-04-011410.3389/fneur.2023.11611981161198Delayed low cerebellar perfusion status is associated with poor outcomes in top-of-basilar occlusion treated with thrombectomyJae-Chan Ryu0Boseong Kwon1Yunsun Song2Deok Hee Lee3Jun Young Chang4Dong-Wha Kang5Sun U. Kwon6Jong S. Kim7Bum Joon Kim8Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaDepartment of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of KoreaDepartment of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaBackground and purposeTop-of-basilar artery occlusion (TOB) is one of the most devastating strokes despite successful mechanical thrombectomy (MT). We aimed to investigate the impact of initial low cerebellum perfusion delay on the outcomes of TOB treated with MT.MethodsWe included patients who underwent MT for TOB. Clinical and peri-procedural variables were obtained. Perfusion delay in the low cerebellum was defined as (1) time-to-maximum (Tmax) >10 s lesions or (2) relative time-to-peak (rTTP) map >9.5 s with a diameter of ≥6 mm in the low cerebellum. The good functional outcome was defined as the achievement of a modified Rankin Scale score of 0–3 at 3 months after stroke.ResultsAmong the 42 included patients, 24 (57.1%) patients showed perfusion delay in the low cerebellum. The admission National Institutes of Health Stroke Scale (NIHSS) score was significantly higher in those with perfusion delay [17 (12–24) vs. 8 (6–15), P = 0.002]. Accordingly, the proportion of good functional outcomes was lower in those with perfusion delay than in those without [5 (20.8%) vs. 13 (72.2%), P = 0.003]. From the multivariable analysis, the admission NIHSS score [odds ratio (OR) = 0.86, 95% confidence intervals (CIs) = 0.75–0.98, P = 0.021] and low cerebellum perfusion delay (OR = 0.18, 95% Cis = 0.04–0.86, P = 0.031) were independently associated with the 3-month functional outcomes.ConclusionWe found that initial perfusion delay proximal to TOB in the low cerebellum might be a predictor for poor functional outcomes in TOB treated with MT.https://www.frontiersin.org/articles/10.3389/fneur.2023.1161198/fullmechanical thrombectomytop-of-basilar artery occlusionperfusionlower cerebellumendovascular treatment (EVT) |
| spellingShingle | Jae-Chan Ryu Boseong Kwon Yunsun Song Deok Hee Lee Jun Young Chang Dong-Wha Kang Sun U. Kwon Jong S. Kim Bum Joon Kim Delayed low cerebellar perfusion status is associated with poor outcomes in top-of-basilar occlusion treated with thrombectomy Frontiers in Neurology mechanical thrombectomy top-of-basilar artery occlusion perfusion lower cerebellum endovascular treatment (EVT) |
| title | Delayed low cerebellar perfusion status is associated with poor outcomes in top-of-basilar occlusion treated with thrombectomy |
| title_full | Delayed low cerebellar perfusion status is associated with poor outcomes in top-of-basilar occlusion treated with thrombectomy |
| title_fullStr | Delayed low cerebellar perfusion status is associated with poor outcomes in top-of-basilar occlusion treated with thrombectomy |
| title_full_unstemmed | Delayed low cerebellar perfusion status is associated with poor outcomes in top-of-basilar occlusion treated with thrombectomy |
| title_short | Delayed low cerebellar perfusion status is associated with poor outcomes in top-of-basilar occlusion treated with thrombectomy |
| title_sort | delayed low cerebellar perfusion status is associated with poor outcomes in top of basilar occlusion treated with thrombectomy |
| topic | mechanical thrombectomy top-of-basilar artery occlusion perfusion lower cerebellum endovascular treatment (EVT) |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1161198/full |
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