Predictive Value of Basilar Artery Apex for Prognosis of Endovascular Treatment in Acute Basilar Artery Occlusion: A Retrospective Cohort Study

Background: Acute basilar artery occlusion (BAO) is a severely fatal and debilitating ischemic disorder. Research on the impact of the basilar artery apex on the prognosis of endovascular treatment (EVT) in BAO is limited. Objectives: This study aims to assess the influence of basilar artery apex imaging on the prognosis of BAO by examining patient imaging data, comorbidities, time of hospital arrival, admission National Institutes of Health Stroke Scale (NIHSS) scores, onset-to-puncture duration, and puncture-to-recanalization interval. This research seeks to identify and assess predictive variables using a least absolute shrinkage and selection operator (LASSO) regression model. Patients and Methods: A total of 59 patients were retrospectively enrolled from Jiangyin People's Hospital. Patients with BAO from 2019 to 2023 were classified into a good 90-day (90d) outcome group (90d mRS of 0 - 2) and a poor 90-day outcome group (90d mRS of 3 - 6) based on the modified Rankin Scale (mRS) scores. A retrospective examination of patient imaging and clinical data was performed. Variables were selected via LASSO/logistic regression and assessed using receiver operating characteristic (ROC) curves. Results: A total of 59 BAO patients were included in this study, with 19 (32.2%) in the good 90d outcome group and 40 (67.8%) in the poor 90d outcome group. The available images of the basilar artery apex were obtained in 14 patients (73.68%). The LASSO regression identified the available image of the basilar artery apex and admission NIHSS as the most significant variables. The subsequent ROC curve analysis validated that the accessible image of the basilar artery apex possesses a distinct capacity to discriminate the prognosis of BAO. Conclusion: Predicting the 90-day clinical outcome of EVT in acute BAO is made possible by the accessible imaging of the basilar artery apex.