{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:34:35Z","timestamp":1759970075284,"version":"build-2065373602"},"reference-count":0,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can. J. Neurol. Sci."],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n\t  <jats:sec id=\"S0317167125104253_as1\">\n\t    <jats:title>Background and aims:<\/jats:title>\n\t    <jats:p>Achieving a first pass recanalization (FPR) improves clinical outcomes in patients with basilar artery strokes, but its association with initial infarct burden is unknown. We aimed to study the benefits of FPR for basilar artery strokes by initial infarct burden using the Posterior Circulation Alberta Stroke Program Early CT score (pc-ASPECTS).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0317167125104253_as2\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>We retrospectively analyzed the prospective multicentric Endovascular Treatment of Ischemic Stroke registry and included 194 patients diagnosed with an acute basilar artery occlusion who were treated with thrombectomy. Our primary outcome was a modified Rankin Scale (mRS) of 0\u20133 at 90 days, and our secondary outcomes were an mRS of 4\u20136 and mortality. We compared the 90-day clinical outcomes of achieving an FPR versus multiple thrombectomy passes based on patients\u2019 initial infarct size on pretreatment MRI: small (pc-ASPECTS = 9\u201310), medium (pc-ASPECTS = 6\u20138) and large (pc-ASPECTS &lt;6).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0317167125104253_as3\">\n\t    <jats:title>Results:<\/jats:title>\n\t    <jats:p>Patients with a medium or large infarct size had significantly better outcomes (mRS 0\u20133 at 3 months) if FPR was achieved than if multiple passes were required (RR = 1.61, 95% CI: 1.16, 2.24; <jats:italic>p<\/jats:italic>-value = 0.005; and RR = 3.41, 95% CI: 1.54\u20137.57; <jats:italic>p<\/jats:italic>-value = 0.003, respectively). No similar difference was seen among patients with small infarcts. Achieving an FPR was also associated with a significantly lower mortality risk among patients with a moderate infarct size (RR = 0.36, 95% CI: 0.17\u20130.79; <jats:italic>p<\/jats:italic>-value = 0.010) but not with those with small or large infarcts.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0317167125104253_as4\">\n\t    <jats:title>Conclusions:<\/jats:title>\n\t    <jats:p>Achieving an FPR significantly improves clinical outcomes in acute stroke patients with basilar artery occlusions undergoing thrombectomy when their infarcts are medium or large. Ongoing research to develop surgical techniques to achieve FPR is crucial to improving patients\u2019 prognoses.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/cjn.2025.10425","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T06:40:52Z","timestamp":1757918452000},"page":"1-7","source":"Crossref","is-referenced-by-count":0,"title":["Benefits of First Pass Recanalization by Initial Infarct Burden for Basilar Artery Strokes"],"prefix":"10.1017","author":[{"given":"Maria","family":"Fahmy","sequence":"first","affiliation":[{"name":"University of Ottawa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1190-2726","authenticated-orcid":false,"given":"Vincent","family":"Brissette","sequence":"additional","affiliation":[{"name":"University of Ottawa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle","family":"Roy","sequence":"additional","affiliation":[{"name":"University of Ottawa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joyce","family":"Beshara","sequence":"additional","affiliation":[{"name":"University of Ottawa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cyril","family":"Dargazanli","sequence":"additional","affiliation":[{"name":"Gui de Chauliac Hospital"},{"name":"Univ. 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Lille"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Weisenburger-Lile","sequence":"additional","affiliation":[{"name":"Foch Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Gory","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lorraine"},{"name":"Universit\u00e9 de Lorraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00e9bastien","family":"Richard","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lorraine"},{"name":"INSERM U1116"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e9lina","family":"Ducroux","sequence":"additional","affiliation":[{"name":"University of Ottawa"},{"name":"The Ottawa Hospital Research Institute"},{"name":"Fondation Rothschild Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel","family":"Piotin","sequence":"additional","affiliation":[{"name":"Fondation Rothschild Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rapha\u00ebl","family":"Blanc","sequence":"additional","affiliation":[{"name":"Fondation Rothschild Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ludovic","family":"Lucas","sequence":"additional","affiliation":[{"name":"Centre Hospitalier D\u2019Arcachon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaultier","family":"Marnat","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Universitaire de Bordeaux"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathilde","family":"Aubertin","sequence":"additional","affiliation":[{"name":"Fondation Rothschild Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Arquizan","sequence":"additional","affiliation":[{"name":"Gui de Chauliac Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Romain","family":"Bourcier","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Universitaire de Bordeaux"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lili","family":"Detraz","sequence":"additional","affiliation":[{"name":"UNIV Nantes"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"St\u00e9phane","family":"Vannier","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Universitaire Pontchaillou"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maud","family":"Guillen","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Universitaire Pontchaillou"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Eugene","sequence":"additional","affiliation":[{"name":"Erasme University Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arturo","family":"Consoli","sequence":"additional","affiliation":[{"name":"Foch Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Costalat","sequence":"additional","affiliation":[{"name":"Gui de Chauliac Hospital"},{"name":"Univ. Montpellier"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bertrand","family":"Lapergue","sequence":"additional","affiliation":[{"name":"Foch Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Ma\u00efer","sequence":"additional","affiliation":[{"name":"Fondation Rothschild Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrien","family":"Guenego","sequence":"additional","affiliation":[{"name":"Fondation Rothschild Hospital"},{"name":"Erasme University Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dar","family":"Dowlatshahi","sequence":"additional","affiliation":[{"name":"University of Ottawa"},{"name":"The Ottawa Hospital Research Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0085-6816","authenticated-orcid":false,"given":"Michel","family":"Shamy","sequence":"additional","affiliation":[{"name":"University of Ottawa"},{"name":"The Ottawa Hospital Research Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1887-5097","authenticated-orcid":false,"given":"Robert","family":"Fahed","sequence":"additional","affiliation":[{"name":"University of Ottawa"},{"name":"The Ottawa Hospital Research Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2025,9,15]]},"container-title":["Canadian Journal of Neurological Sciences \/ Journal Canadien des Sciences Neurologiques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0317167125104253","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:20:00Z","timestamp":1759918800000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0317167125104253\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,15]]},"references-count":0,"alternative-id":["S0317167125104253"],"URL":"https:\/\/doi.org\/10.1017\/cjn.2025.10425","relation":{},"ISSN":["0317-1671","2057-0155"],"issn-type":[{"type":"print","value":"0317-1671"},{"type":"electronic","value":"2057-0155"}],"subject":[],"published":{"date-parts":[[2025,9,15]]}}}