Basilar Artery On Computed Tomography Angiography Score And Clinical Outcomes In Acute Basilar Artery Occlusion

Objectives: This study aimed to evaluate the safety and efficacy of endovascular treatment（EVT）in patients with acute basilar artery occlusion（BAO）based on the baseline Basilar Artery on Computed Tomography Angiography（BATMAN）score.Methods: We selected patients from the BASILAR study and analyzed the effects and safety of standard medical therapy（SMT）and EVT for patients with documented BATMAN scores.The patients were subgrouped into three based on the BATMAN score（0-3,4-6,7-10）.The primary outcome was a favorable functional outcome（modified Rankin Scale [m RS] ≤3）and mortality after 90 days.Results: This study included 828 patients: 337 with low BATMAN scores of 0–3,386 with moderate BATMAN scores of 4–6,and 105 with good BATMAN scores of 7–10.Among these three subgroups,the subgroup with good BATMAN scores comprised younger participants and had lower NIHSS scores,less frequent history of coronary heart disease,and a higher prevalence of middle basilar artery occlusion.Other variables were matched between the subgroups.EVT was associated with favorable functional outcomes in the poor（adjusted odds ratio（a OR）,11.96;95% confidence interval（CI）,2.58-55.43;P=0.002）,moderate（a OR,4.66;95% CI,2.11-10.28;P<0.001）,and good（a OR,7.71;95% CI,2.20-27.02;P=0.001）subgroups.EVT was also associated with low mortality rates in the poor（a OR,0.10;95% CI,0.04-0.27;P<0.001）and moderate（a OR,0.31;95% CI,0.16-0.57;P=0.002）subgroups.The BATMAN score was significantly associated with favorable outcomes in both SMT（a OR,1.44;95% CI,1.08-1.93;P=0.014）and EVT（a OR,1.31;95% CI,1.20-1.44;P<0.001）groups.Furthermore,after adjusting for factors such as BATMAN score,the puncture to recanalization time was not associated with favorable outcomes（a OR,1.00;95% CI,0.99-1.00;P=0.216）,but the puncture to recanalization time was significantly associated with it（a OR,0.99;95% CI,0.99-1.00;P<0.001）.Conclusion: Higher BATMAN scores were associated with improved prognosis and lower mortality rates after 3 months.EVT was associated with improved outcomes in patients with low BATMAN scores despite their worse overall outcomes.