{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T13:12:37Z","timestamp":1782997957588,"version":"3.54.5"},"reference-count":32,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The efficacy of endovascular thrombectomy in patients with posterior circulation ischemic stroke remains controversial. Early neurological deterioration (END) as an important predictor of poor outcome is poorly understood, except in cases of symptomatic intracranial hemorrhage, recanalization failure, and malignant cerebral edema. The objective of this study was to assess predictors of unexplained END (UnEND) after endovascular thrombectomy.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The BASILAR study is a multicenter prospective observational study in which 647 patients with vertebrobasilar occlusion on imaging within 24 hours of stroke onset and who underwent endovascular treatment were enrolled, of whom 477 who had undergone successful recanalization were included in this study. Multivariate analysis was used to identify the predictors of UnEND, defined as a \u2265 4-point increase in National Institutes of Health Stroke Scale (NIHSS) score at 24 hours after endovascular thrombectomy.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Among the 477 eligible patients included, UnEND occurred in 86 (18%) patients. The predictors of UnEND were stress hyperglycemic ratio (SHR) (OR 2.2, 95% CI 1.1\u20134.6; p = 0.031), baseline NIHSS score (OR 0.9, 95% CI 0.83\u20130.95; p = 0.001), and asymptomatic intracerebral hemorrhage (aICH) (OR 5.9, 95% CI 1.7\u201320.0; p = 0.004). The occurrence rate of a favorable outcome, defined as a modified Rankin Scale score of 0\u20133 at 90 days, was lower in the UnEND group (5.8% vs 47.6%, p &lt; 0.001) compared with the group without END, and the UnEND group had higher mortality at 90 days (66.3% vs 27.4%, p &lt; 0.001).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>UnEND may be associated with poor outcome after endovascular thrombectomy in patients with acute vertebrobasilar occlusion. Some modifiable factors such as SHR and aICH could be targeted to improve the efficacy of endovascular thrombectomy.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.4.jns232632","type":"journal-article","created":{"date-parts":[[2024,6,22]],"date-time":"2024-06-22T01:29:25Z","timestamp":1719019765000},"page":"1705-1711","source":"Crossref","is-referenced-by-count":4,"title":["Predictors of unexplained early neurological deterioration after thrombectomy for posterior circulation infarction: a reanalysis of the BASILAR study"],"prefix":"10.3171","volume":"141","author":[{"given":"Zheng","family":"Dai","sequence":"first","affiliation":[{"name":"Departments of Neurology and"},{"name":"Department of Neurology, Jinling Hospital, Nanjing Medical University, Nanjing;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daoyou","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xingyi People\u2019s Hospital, Xingyi;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daizhou","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Neurology, Qianxinan People\u2019s Hospital, Xingyi;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunxin","family":"Wang","sequence":"additional","affiliation":[{"name":"Medical Imaging, The Affiliated Wuxi People\u2019s Hospital of Nanjing Medical University, Wuxi People\u2019s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaoyu","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Neurology, Qianxinan People\u2019s Hospital, Xingyi;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dahong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinrong","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengli","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjie","family":"Zi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuming","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shantou Central Hospital, Shantou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"8","key":"b1","series-title":"J Neurointerv Surg","first-page":"783","article-title":"Posterior circulation CT angiography collaterals predict outcome of endovascular acute ischemic stroke therapy for basilar artery occlusion","volume":"8","author":"Goyal N","year":"2016","unstructured":"Goyal N, Tsivgoulis G, Nickele C,  Posterior circulation CT angiography collaterals predict outcome of endovascular acute ischemic stroke therapy for basilar artery occlusion. 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