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Predicting outcomes after acute reperfusion therapy for basilar artery occlusion.

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Title: Predicting outcomes after acute reperfusion therapy for basilar artery occlusion.
Authors: Jadhav, A. P. (AUTHOR), Desai, S. M. (AUTHOR), Panczykowski, D. M. (AUTHOR), Rangaraju, S. (AUTHOR), Campbell, D. (AUTHOR), Ritvonen, J. K. (AUTHOR), Schreiner, M. (AUTHOR), Silvennoinen, H. (AUTHOR), Gerber, J. (AUTHOR), Puetz, V. (AUTHOR), Raza, S. A. (AUTHOR), Haussen, D. C. (AUTHOR), Nogueira, R. G. (AUTHOR), Strbian, D. (AUTHOR), Jovin, T. G. (AUTHOR), Lindsberg, P. J. (AUTHOR)
Source: European Journal of Neurology. Nov2020, Vol. 27 Issue 11, p2176-2184. 9p.
Subjects: Basilar artery, Reperfusion, Magnetic resonance imaging, Regression analysis, Multivariate analysis
Geographic Terms: Europe
Abstract: Background and purpose: Basilar artery occlusion (BAO) leads to high rates of morbidity and mortality, despite successful recanalization. The discordance between flow restoration and long‐term functional status clouds clinical decision‐making regarding further aggressive care. We sought to develop and validate a practical, prognostic tool for the prediction of 3‐month favorable outcome after acute reperfusion therapy for BAO. Methods: This retrospective, multicenter, observational study was conducted at four high‐volume stroke centers in the USA and Europe. Multivariate regression analysis was performed to identify predictors of favorable outcome (90‐day modified Rankin scale scores 0–2) and derive a clinically applicable prognostic model (the Pittsburgh Outcomes after Stroke Thrombectomy‐Vertebrobasilar (POST‐VB) score). The POST‐VB score was evaluated and internally validated with regard to calibration and discriminatory ability. External validity was assessed in patient cohorts at three separate centers. Results: In the derivation cohort of 59 patients, independent predictors of favorable outcome included smaller brainstem infarct volume on post‐procedure magnetic resonance imaging (P < 0.01) and younger age (P = 0.01). POST‐VB score was calculated as: age + (10 × brainstem infarct volume). POST‐VB score demonstrated excellent discriminatory ability [area under the receiver‐operating characteristic curve (AUC) = 0.91] and adequate calibration (P = 0.88) in the derivation cohort (Center A). It performed equally well across the three external validation cohorts (Center B, AUC = 0.89; Center C, AUC = 0.78; Center D, AUC = 0.80). Overall, a POST‐VB score < 49 was associated with an 88% likelihood of favorable outcome, as compared to 4% with a score ≥ 125. Conclusions: The POST‐VB score effectively predicts 3‐month functional outcome following acute reperfusion therapy for BAO and may aid in guiding post‐procedural care. [ABSTRACT FROM AUTHOR]
Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Predicting outcomes after acute reperfusion therapy for basilar artery occlusion.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Jadhav%2C+A%2E+P%2E%22&quot;&gt;Jadhav, A. P.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Desai%2C+S%2E+M%2E%22&quot;&gt;Desai, S. M.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Panczykowski%2C+D%2E+M%2E%22&quot;&gt;Panczykowski, D. M.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Rangaraju%2C+S%2E%22&quot;&gt;Rangaraju, S.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Campbell%2C+D%2E%22&quot;&gt;Campbell, D.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ritvonen%2C+J%2E+K%2E%22&quot;&gt;Ritvonen, J. K.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Schreiner%2C+M%2E%22&quot;&gt;Schreiner, M.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Silvennoinen%2C+H%2E%22&quot;&gt;Silvennoinen, H.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Gerber%2C+J%2E%22&quot;&gt;Gerber, J.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Puetz%2C+V%2E%22&quot;&gt;Puetz, V.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Raza%2C+S%2E+A%2E%22&quot;&gt;Raza, S. A.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Haussen%2C+D%2E+C%2E%22&quot;&gt;Haussen, D. C.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Nogueira%2C+R%2E+G%2E%22&quot;&gt;Nogueira, R. G.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Strbian%2C+D%2E%22&quot;&gt;Strbian, D.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Jovin%2C+T%2E+G%2E%22&quot;&gt;Jovin, T. G.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Lindsberg%2C+P%2E+J%2E%22&quot;&gt;Lindsberg, P. J.&lt;/searchLink&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22European+Journal+of+Neurology%22&quot;&gt;European Journal of Neurology&lt;/searchLink&gt;. Nov2020, Vol. 27 Issue 11, p2176-2184. 9p.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Basilar+artery%22&quot;&gt;Basilar artery&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Reperfusion%22&quot;&gt;Reperfusion&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Magnetic+resonance+imaging%22&quot;&gt;Magnetic resonance imaging&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Regression+analysis%22&quot;&gt;Regression analysis&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Multivariate+analysis%22&quot;&gt;Multivariate analysis&lt;/searchLink&gt;
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– Name: Abstract
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  Data: Background and purpose: Basilar artery occlusion (BAO) leads to high rates of morbidity and mortality, despite successful recanalization. The discordance between flow restoration and long‐term functional status clouds clinical decision‐making regarding further aggressive care. We sought to develop and validate a practical, prognostic tool for the prediction of 3‐month favorable outcome after acute reperfusion therapy for BAO. Methods: This retrospective, multicenter, observational study was conducted at four high‐volume stroke centers in the USA and Europe. Multivariate regression analysis was performed to identify predictors of favorable outcome (90‐day modified Rankin scale scores 0–2) and derive a clinically applicable prognostic model (the Pittsburgh Outcomes after Stroke Thrombectomy‐Vertebrobasilar (POST‐VB) score). The POST‐VB score was evaluated and internally validated with regard to calibration and discriminatory ability. External validity was assessed in patient cohorts at three separate centers. Results: In the derivation cohort of 59 patients, independent predictors of favorable outcome included smaller brainstem infarct volume on post‐procedure magnetic resonance imaging (P &lt; 0.01) and younger age (P = 0.01). POST‐VB score was calculated as: age + (10 &#215; brainstem infarct volume). POST‐VB score demonstrated excellent discriminatory ability [area under the receiver‐operating characteristic curve (AUC) = 0.91] and adequate calibration (P = 0.88) in the derivation cohort (Center A). It performed equally well across the three external validation cohorts (Center B, AUC = 0.89; Center C, AUC = 0.78; Center D, AUC = 0.80). Overall, a POST‐VB score &lt; 49 was associated with an 88% likelihood of favorable outcome, as compared to 4% with a score ≥ 125. Conclusions: The POST‐VB score effectively predicts 3‐month functional outcome following acute reperfusion therapy for BAO and may aid in guiding post‐procedural care. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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      – SubjectFull: Basilar artery
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