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Advanced Neurology

ORIGINAL RESEARCH ARTICLE
Predicting futile recanalization risk in acute

basilar artery occlusion: Combination of
collateral status and pre-procedural systemic

inflammation response index

1
2
1
Yao-Wu Liu , Bo Du 1,2,3† , Bilal Muhammad , Qi-Yang Yuan , Shuo Li ,
1†
1
1,2
Jin-Jin Yang , Yan-Bo Cheng , Shi-Guang Zhu , Dian-Shuai Gao *, and
1,2
1,3
De-Qin Geng 1,2,3 *
1 Department of Neurology, Faculty of First Clinical Medical, Xuzhou Medical University, Xuzhou,
Jiangsu Province, China
2 Department of Neurology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu
Province, China
3 Department of Neurology, Faculty of Xuzhou Medical University, Nanjing Medical University,
Nanjing, Jiangsu Province, China
Abstract
† These authors contributed equally Acute basilar artery occlusion (ABAO) is a rare form of acute ischemic stroke (AIS).
to this work. Endovascular treatment (EVT) has emerged as a primary therapeutic approach for
*Corresponding authors: achieving early reperfusion of the ischemic area. However, a favorable prognosis
Dian-Shuai Gao remains elusive for a considerable number of patient post-recanalization. The
(gds@xzhmu.edu.cn)
De-Qin Geng assessment of disparities in hematological and radiological indicators is of notable
(gengdeqin@126.com) significance for predicting the prognosis of AIS patients. Our study aimed to predict
Citation: Liu Y, Du B, futile recanalization (FR) by analyzing inflammation levels and collateral status in
Muhammad B, et al., 2023, Predicting ABAO patients treated with EVT. Clinical data were collected from January 2019 to
futile recanalization risk in acute March 2023. The angiographic collateral grading system for basilar artery occlusion
basilar artery occlusion: Combination
of collateral status and pre-procedural (ACGS-BAO) and the systemic inflammation response index (SIRI) was employed to
systemic in lammation response assess the collateral status and inflammation levels, respectively. FR was defined as
index. Adv Neuro, 2(4): 1641. patients experiencing an unfavorable functional outcome (modified Rankin Scale >2)
https://doi.org/10.36922/an.1641 at 3-month post-EVT, despite successful recanalization (modified Thrombolysis in
Received: August 20, 2023 Cerebral Infarction 2b or 3). Logistic regression models were utilized to analyze the
Accepted: November 28, 2023 association of ACGS-BAO and SIRI with FR. A total of 72 (65.5%) patients developed
FR. Multivariate logistic analysis revealed that ACGS-BAO (odds ratio [OR]: 0.343, 95%
Published Online: December 12,
2023 confidence interval [CI]: 0.179 – 0.658, P = 0.001), procedure time (OR: 1.028, 95%
CI: 1.007 – 1.050, P = 0.01), and natural logarithm-transformed of the SIRI (Ln[SIRI])
Copyright: © 2023 Author(s). (OR: 2.857, 95% CI: 1.518 – 5.380, P = 0.001) were independently associated with FR.
This is an Open-Access article
distributed under the terms of the In receiver operating characteristic analysis, the area under the curve for ACGS-BAO
Creative Commons Attribution combined SIRI was 0.789 (95% CI: 0.699 – 0.878; P < 0.001). The effects of ACGS-BAO
License, permitting distribution, and Ln(SIRI) on FR were similar in all subgroups (P > 0.10 for all interactions). In
and reproduction in any medium,
provided the original work is conclusion, poor collateral status and high inflammatory levels are independent
properly cited. predictors of FR after EVT in patients with ABAO.
Publisher’s Note: AccScience
Publishing remains neutral with
regard to jurisdictional claims in Keywords: Futile recanalization; Collateral status; Inflammatory; Thrombectomy;
published maps and institutional Ischemic stroke
affiliations.

Volume 2 Issue 4 (2023) 1 https://doi.org/10.36922/an.1641