Factors Determining Prognosis in Patients Undergoing Thrombectomy for Basilar Artery Occlusion

Background: In this study, we aimed to investigate the factors that may affect the prognosis of patients who underwent endovascular treatment for basilar artery occlusion (BAO). Methods:The data of patients admitted to the Dicle University Stroke Center between January 1, 2019, and April 1, 2024, were retrospectively analyzed.Patients with conditions that could affect prognosis, such as prior sequelae, malignancy, or receiving thrombolytic therapy before endovascular treatment, were excluded.A total of 38 patients met the inclusion criteria.The patients' admission and 24-hour post-procedure National Health Stroke Scale score (NI-HSS), admission Glascow Coma Scale (GCS) score, basilar artery occlusion segments, Thrombolysis in Cerebral Infarction (TICI) recanalization score, 3-month modified Rankin score (mRS), and the number of PASS attempts performed for recanalization were evaluated.Additionally, preoperative lymphocyte, hematocrit, neutrophil counts, and neutrophil-to-lymphocyte ratios (NLR) were calculated.The relationships between these factors and prognosis and mortality were analyzed.Results: In our study, which retrospectively evaluated a total of 38 patients, the factors statistically significantly associated with functional independence (mRS 0-3) at the 3-month mRS score were the admission NIHSS score, the 24-hour NIHSS score, and the number of PASS attempts performed for recanalization (P=.005,P<.001, and P=.048, respectively).mRS scores of 4-6 were considered functionally dependent.Based on the results of the ROC and multivariable logistic regression analyses, the preoperative NLR value appears to be an independent predictor of mortality (AUC: 0.898, P=.029, 95% CI=1.064-3.434).In both ROC and regression analyses, lymphocyte levels were not associated with mortality. Conclusion:Although the number of patients in our study is limited, our results are consistent with many studies on EVT performed for BAO.Additionally, we believe that identifying the relationship between preoperative NLR and mortality is valuable.In this context, we hope that our study can shed new light on the pathophysiology of ischemic stroke and the evaluation of patient prognosis after EVT.