{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T19:18:29Z","timestamp":1789154309886,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,12,3]],"date-time":"2021-12-03T00:00:00Z","timestamp":1638489600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Perfusion imaging identifies anterior circulation stroke patients who respond favorably to endovascular thrombectomy (ET), but its role in basilar artery occlusion (BAO) is unknown. We hypothesized that BAO patients with limited regions of severe hypoperfusion (time to reach maximum concentration in seconds [Tmax] &gt;\u200910) would have a favorable response to ET compared to patients with more extensive regions involved.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a multicenter retrospective cohort study of BAO patients with perfusion imaging prior to ET. We prespecified a Critical Area Perfusion Score (CAPS; 0\u20136 points), which quantified severe hypoperfusion (Tmax &gt;\u200910) in cerebellum (1 point\/hemisphere), pons (2 points), and midbrain and\/or thalamus (2 points). Patients were dichotomized into favorable (CAPS\u2009\u2264\u20093) and unfavorable (CAPS\u2009&gt;\u20093) groups. The primary outcome was a favorable functional outcome 90\u2009days after ET (modified Rankin Scale\u00a0=\u00a00\u20133).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred three patients were included. CAPS\u2009\u2264\u20093 patients (87%) had a lower median National Institutes of Health Stroke Scale score (NIHSS; 12.5, interquartile range [IQR] =\u20097\u201322) compared to CAPS &gt;\u20093 patients (13%; 23, IQR\u00a0=\u00a019\u201336; <jats:italic>p<\/jats:italic>\u00a0=\u20090.01). Reperfusion was achieved in 84% of all patients, with no difference between CAPS groups (<jats:italic>p<\/jats:italic>\u00a0=\u20090.42). Sixty\u2010four percent of reperfused CAPS\u2009\u2264\u20093 patients had a favorable outcome compared to 8% of nonreperfused CAPS\u2009\u2264\u20093 patients (odds ratio [OR]\u00a0=\u00a021.0, 95% confidence interval [CI] =\u20092.6\u2013170; <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001). No CAPS\u2009&gt;\u20093 patients had a favorable outcome, regardless of reperfusion. In a multivariate regression analysis, CAPS\u2009\u2264\u20093 was a robust independent predictor of favorable outcome after adjustment for reperfusion, age, and pre\u2010ET NIHSS (OR\u00a0=\u00a039.25, 95% CI\u00a0=\u00a01.34\u2013&gt;999, <jats:italic>p<\/jats:italic>\u00a0=\u20090.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>BAO patients with limited regions of severe hypoperfusion had a favorable response to reperfusion following ET. However, patients with more extensive regions of hypoperfusion in critical brain regions did not benefit from endovascular reperfusion. ANN NEUROL 2022;91:23\u201332<\/jats:p><\/jats:sec>","DOI":"10.1002\/ana.26272","type":"journal-article","created":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T09:20:32Z","timestamp":1637140832000},"page":"23-32","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Perfusion Imaging Predicts Favorable Outcomes after Basilar Artery Thrombectomy"],"prefix":"10.1002","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6479-1476","authenticated-orcid":false,"given":"Carlo W.","family":"Cereda","sequence":"first","affiliation":[{"name":"Stroke Center, Neurology Neurocenter of Southern Switzerland, EOC  Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Bianco","sequence":"additional","affiliation":[{"name":"Stroke Center, Neurology Neurocenter of Southern Switzerland, EOC  Lugano 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