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@ARTICLE{Maus:841765,
      author       = {Maus, Volker and Kalkan, Alev and Kabbasch, Christoph and
                      Abdullayev, Nuran and Stetefeld, Henning and Barnikol, Utako
                      Birgit and Liebig, Thomas and Dohmen, Christian and Fink,
                      Gereon Rudolf and Borggrefe, Jan and Mpotsaris, Anastasios},
      title        = {{M}echanical {T}hrombectomy in {B}asilar {A}rtery
                      {O}cclusion},
      journal      = {Clinical neuroradiology},
      volume       = {29},
      number       = {1},
      issn         = {1869-1447},
      address      = {München},
      publisher    = {Urban $\&$ Vogel},
      reportid     = {FZJ-2018-00069},
      pages        = {153–160},
      year         = {2019},
      abstract     = {BackgroundMechanical thrombectomy (MT) of basilar artery
                      occlusions (BAO) is a subject of debate. We investigated the
                      clinical outcome of MT in BAO and predictors of a favorable
                      outcome.Material and MethodsA total of 104 MTs of BAO
                      (carried out between 2010 and 2016) were analyzed. Favorable
                      outcome as a modified Rankin scale (mRS) ≤ 2 at 90 days
                      was the primary endpoint. The influence of the following
                      variables on outcome was investigated: number of detectable
                      posterior communicating arteries (PcoAs), patency of basilar
                      tip, completeness of BAO and posterior circulation Alberta
                      Stroke Program early computed tomography score (PC-ASPECTS).
                      Secondary endpoints were technical periprocedural parameters
                      including symptomatic intracranial hemorrhage
                      (sICH).ResultsThe favorable clinical outcome at 90 days was
                      $25\%$ and mortality was $43\%.$ The rate of successful
                      reperfusion, i.e. modified thrombolysis in cerebral
                      infarction (mTICI) ≥ 2b was $82\%.$ Presence of bilateral
                      PcoAs (area under the curve, AUC: 0.81, odds ratio, OR: 4.2,
                      2.2–8.2; p < 0.0001), lower National Institute of Health
                      Stroke Scale (NIHSS) on admission (AUC: 0.74, OR: 2.6,
                      1.3–5.2; p < 0.01), PC-ASPECTS ≥ 9 (AUC: 0.72, OR: 4.2,
                      1.5–11.9; p < 0.01), incomplete BAO (AUC: 0.66, OR: 2.6,
                      1.4–4.8; p < 0.001), and basilar tip patency (AUC: 0.66,
                      OR: 2.5, 1.3–4.8; p < 0.01) were associated with a
                      favorable outcome. Stepwise logistic regression analysis
                      revealed that the strongest predictors of favorable outcome
                      at 90 days were bilateral PcoAs, low NIHSS on admission, and
                      incomplete BAO (AUC: 0.923, OR: 7.2, 3–17.3; p <
                      0.0001).ConclusionThe use of MT for BAO is safe with high
                      rates of successful reperfusion. Aside from baseline NIHSS
                      and incomplete vessel occlusion, both known predictors of
                      favorable outcome in anterior circulation events, we found
                      that collateral flow based on the presence or absence of
                      PcoAs had a decisive prognostic impact.},
      cin          = {INM-3},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406},
      pnm          = {572 - (Dys-)function and Plasticity (POF3-572)},
      pid          = {G:(DE-HGF)POF3-572},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29260256},
      UT           = {WOS:000459774900018},
      doi          = {10.1007/s00062-017-0651-3},
      url          = {https://juser.fz-juelich.de/record/841765},
}