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Higher baseline blood glucose is associated with reduced likelihood for successful recanalization in patients with basilar artery occlusion

PURPOSE: Evidence regarding the effect of mechanical thrombectomy (MT) of basilar artery occlusion (BAO) stroke is yet sparse. As successful recanalization has been suggested as major determinant of outcome, the early identification of modifiable factors associated with successful recanalization cou...

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Autores principales: Broocks, Gabriel, Groffmann, Maximilian, Meyer, Lukas, Elsayed, Sarah, Kniep, Helge, Kemmling, Andre, van Horn, Noel, McDonough, Rosalie, Faizy, Tobias D., Bechstein, Matthias, Sporns, Peter, Rusche, Thilo, Schön, Gerhard, Nawabi, Jawed, Fiehler, Jens, Hanning, Uta
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9120087/
https://www.ncbi.nlm.nih.gov/pubmed/34984515
http://dx.doi.org/10.1007/s00415-021-10948-1
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author Broocks, Gabriel
Groffmann, Maximilian
Meyer, Lukas
Elsayed, Sarah
Kniep, Helge
Kemmling, Andre
van Horn, Noel
McDonough, Rosalie
Faizy, Tobias D.
Bechstein, Matthias
Sporns, Peter
Rusche, Thilo
Schön, Gerhard
Nawabi, Jawed
Fiehler, Jens
Hanning, Uta
author_facet Broocks, Gabriel
Groffmann, Maximilian
Meyer, Lukas
Elsayed, Sarah
Kniep, Helge
Kemmling, Andre
van Horn, Noel
McDonough, Rosalie
Faizy, Tobias D.
Bechstein, Matthias
Sporns, Peter
Rusche, Thilo
Schön, Gerhard
Nawabi, Jawed
Fiehler, Jens
Hanning, Uta
author_sort Broocks, Gabriel
collection PubMed
description PURPOSE: Evidence regarding the effect of mechanical thrombectomy (MT) of basilar artery occlusion (BAO) stroke is yet sparse. As successful recanalization has been suggested as major determinant of outcome, the early identification of modifiable factors associated with successful recanalization could be of importance to improve functional outcome. Hyperglycemia has been associated with enhanced thrombin generation and unfavorably altered clot features. OBJECTIVE: We hypothesized that serum baseline glucose is associated with likelihood of vessel recanalization mediated by collateral quality and clot burden in BAO stroke. METHODS: BAO stroke patients who received multimodal CT on admission were analyzed. The association of vessel recanalization defined using modified Thrombolysis in cerebral infarction scale (mTICI) scores 2b-3, and baseline imaging and clinical parameters were tested in logistic regression analyses. Collateral quality and clot burden were evaluated using the Basilar Artery on CT-Angiography (BATMAN) score. RESULTS: Out of 117 BAO patients, 91 patients (78%) underwent MT. In 70 patients (77%), successful recanalization could be achieved (mTICI 2b/3). In multivariable logistic regression analysis, only a higher BGL (aOR 0.97, 95% CI 0.96–0.99, p = 0.03) and higher BATMAN score (aOR 1.77, 95% CI 1.11–2.82, p = 0.02) were independently associated with vessel recanalization. Application of alteplase, or time from symptom onset-imaging revealed no independent association with recanalization status. CONCLUSION: Higher BGL was significantly associated with reduced likelihood for recanalization success besides BATMAN score as a measure of collateral quality and clot burden. BGL could be tested as a modifiable parameter to increase likelihood for recanalization in BAO stroke, aiming to improve functional outcome. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00415-021-10948-1.
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spelling pubmed-91200872022-05-21 Higher baseline blood glucose is associated with reduced likelihood for successful recanalization in patients with basilar artery occlusion Broocks, Gabriel Groffmann, Maximilian Meyer, Lukas Elsayed, Sarah Kniep, Helge Kemmling, Andre van Horn, Noel McDonough, Rosalie Faizy, Tobias D. Bechstein, Matthias Sporns, Peter Rusche, Thilo Schön, Gerhard Nawabi, Jawed Fiehler, Jens Hanning, Uta J Neurol Original Communication PURPOSE: Evidence regarding the effect of mechanical thrombectomy (MT) of basilar artery occlusion (BAO) stroke is yet sparse. As successful recanalization has been suggested as major determinant of outcome, the early identification of modifiable factors associated with successful recanalization could be of importance to improve functional outcome. Hyperglycemia has been associated with enhanced thrombin generation and unfavorably altered clot features. OBJECTIVE: We hypothesized that serum baseline glucose is associated with likelihood of vessel recanalization mediated by collateral quality and clot burden in BAO stroke. METHODS: BAO stroke patients who received multimodal CT on admission were analyzed. The association of vessel recanalization defined using modified Thrombolysis in cerebral infarction scale (mTICI) scores 2b-3, and baseline imaging and clinical parameters were tested in logistic regression analyses. Collateral quality and clot burden were evaluated using the Basilar Artery on CT-Angiography (BATMAN) score. RESULTS: Out of 117 BAO patients, 91 patients (78%) underwent MT. In 70 patients (77%), successful recanalization could be achieved (mTICI 2b/3). In multivariable logistic regression analysis, only a higher BGL (aOR 0.97, 95% CI 0.96–0.99, p = 0.03) and higher BATMAN score (aOR 1.77, 95% CI 1.11–2.82, p = 0.02) were independently associated with vessel recanalization. Application of alteplase, or time from symptom onset-imaging revealed no independent association with recanalization status. CONCLUSION: Higher BGL was significantly associated with reduced likelihood for recanalization success besides BATMAN score as a measure of collateral quality and clot burden. BGL could be tested as a modifiable parameter to increase likelihood for recanalization in BAO stroke, aiming to improve functional outcome. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00415-021-10948-1. Springer Berlin Heidelberg 2022-01-04 2022 /pmc/articles/PMC9120087/ /pubmed/34984515 http://dx.doi.org/10.1007/s00415-021-10948-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Communication
Broocks, Gabriel
Groffmann, Maximilian
Meyer, Lukas
Elsayed, Sarah
Kniep, Helge
Kemmling, Andre
van Horn, Noel
McDonough, Rosalie
Faizy, Tobias D.
Bechstein, Matthias
Sporns, Peter
Rusche, Thilo
Schön, Gerhard
Nawabi, Jawed
Fiehler, Jens
Hanning, Uta
Higher baseline blood glucose is associated with reduced likelihood for successful recanalization in patients with basilar artery occlusion
title Higher baseline blood glucose is associated with reduced likelihood for successful recanalization in patients with basilar artery occlusion
title_full Higher baseline blood glucose is associated with reduced likelihood for successful recanalization in patients with basilar artery occlusion
title_fullStr Higher baseline blood glucose is associated with reduced likelihood for successful recanalization in patients with basilar artery occlusion
title_full_unstemmed Higher baseline blood glucose is associated with reduced likelihood for successful recanalization in patients with basilar artery occlusion
title_short Higher baseline blood glucose is associated with reduced likelihood for successful recanalization in patients with basilar artery occlusion
title_sort higher baseline blood glucose is associated with reduced likelihood for successful recanalization in patients with basilar artery occlusion
topic Original Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9120087/
https://www.ncbi.nlm.nih.gov/pubmed/34984515
http://dx.doi.org/10.1007/s00415-021-10948-1
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