The Basilar Artery Collateral Simplified Score: a Novel Collateral Circulation Score Associated With Outcomes in Patients With Basilar Artery Occlusion: Results From the ATTENTION Study
Background The aim of the current study was to develop a simplified collateral score for basilar artery occlusion and assess its impact on the relationship between procedure time and outcomes. Methods and Results The derivation cohort (n=221) from the ATTENTION (Endovascular Treatment for Acute Basi...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-03-01
|
| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.038271 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850233799830405120 |
|---|---|
| author | Cong Luo Rui Li Chunrong Tao Ming Cai Lang Chen Peng Hao Xinfeng Liu Wei Hu |
| author_facet | Cong Luo Rui Li Chunrong Tao Ming Cai Lang Chen Peng Hao Xinfeng Liu Wei Hu |
| author_sort | Cong Luo |
| collection | DOAJ |
| description | Background The aim of the current study was to develop a simplified collateral score for basilar artery occlusion and assess its impact on the relationship between procedure time and outcomes. Methods and Results The derivation cohort (n=221) from the ATTENTION (Endovascular Treatment for Acute Basilar Artery Occlusion) study was used. Variables identified by logistic regression were used to develop the Basilar Artery Collateral Simplified Score (BACSS). Its performance was assessed through discrimination and calibration. BACSS was evaluated in an external cohort (n=191). The association between BACSS and outcomes was evaluated using adjusted logistic regression. In patients receiving endovascular treatment, associations of BACSS and time from puncture to recanalization with outcomes were evaluated, including an interaction term (BACSS×puncture to recanalization) to assess effect modification. The primary outcome was 90‐day functional independence (modified Rankin Scale score ≤2). Posterior communicating artery, posterior cerebral artery, and superior cerebellar artery were identified through multivariable logistic regression to establish BACSS. The area under the curve of BACSS was 0.749 (95% CI, 0.679–0.819), comparable to the Basilar Artery on Computed Tomography Angiography score and Posterior Circulation Collateral Score, with substantial interobserver agreement. Both the calibration curves and the Hosmer‐Lemeshow test showed good calibration. Similar findings were observed in the external cohort. BACSS was independently associated with functional independence (adjusted odds ratio, 2.11 [95% CI, 1.53–3.02]). The relationship between puncture to recanalization and outcomes (Pinteraction>0.05) was unchanged. Conclusions BACSS is a simple collateral score with improved interobserver reliability and shows a positive association with outcomes in basilar artery occlusion. In patients with basilar artery occlusion, shorter procedure time during endovascular treatment is associated with favorable outcome, regardless of collateral circulation. Registration URL: https://www.clinicaltrials.gov; Unique Identifier: NCT04751708. |
| format | Article |
| id | doaj-art-665c653d4b5444dbbefc041a3da63e32 |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-665c653d4b5444dbbefc041a3da63e322025-08-20T02:02:50ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-03-0114610.1161/JAHA.124.038271The Basilar Artery Collateral Simplified Score: a Novel Collateral Circulation Score Associated With Outcomes in Patients With Basilar Artery Occlusion: Results From the ATTENTION StudyCong Luo0Rui Li1Chunrong Tao2Ming Cai3Lang Chen4Peng Hao5Xinfeng Liu6Wei Hu7Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine University of Science and Technology of China Hefei Anhui ChinaDepartment of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine University of Science and Technology of China Hefei Anhui ChinaDepartment of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine University of Science and Technology of China Hefei Anhui ChinaDepartment of Neurology Provincial Hospital Affiliated to Anhui Medical University Hefei ChinaDepartment of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine University of Science and Technology of China Hefei Anhui ChinaDepartment of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine University of Science and Technology of China Hefei Anhui ChinaDepartment of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine University of Science and Technology of China Hefei Anhui ChinaDepartment of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine University of Science and Technology of China Hefei Anhui ChinaBackground The aim of the current study was to develop a simplified collateral score for basilar artery occlusion and assess its impact on the relationship between procedure time and outcomes. Methods and Results The derivation cohort (n=221) from the ATTENTION (Endovascular Treatment for Acute Basilar Artery Occlusion) study was used. Variables identified by logistic regression were used to develop the Basilar Artery Collateral Simplified Score (BACSS). Its performance was assessed through discrimination and calibration. BACSS was evaluated in an external cohort (n=191). The association between BACSS and outcomes was evaluated using adjusted logistic regression. In patients receiving endovascular treatment, associations of BACSS and time from puncture to recanalization with outcomes were evaluated, including an interaction term (BACSS×puncture to recanalization) to assess effect modification. The primary outcome was 90‐day functional independence (modified Rankin Scale score ≤2). Posterior communicating artery, posterior cerebral artery, and superior cerebellar artery were identified through multivariable logistic regression to establish BACSS. The area under the curve of BACSS was 0.749 (95% CI, 0.679–0.819), comparable to the Basilar Artery on Computed Tomography Angiography score and Posterior Circulation Collateral Score, with substantial interobserver agreement. Both the calibration curves and the Hosmer‐Lemeshow test showed good calibration. Similar findings were observed in the external cohort. BACSS was independently associated with functional independence (adjusted odds ratio, 2.11 [95% CI, 1.53–3.02]). The relationship between puncture to recanalization and outcomes (Pinteraction>0.05) was unchanged. Conclusions BACSS is a simple collateral score with improved interobserver reliability and shows a positive association with outcomes in basilar artery occlusion. In patients with basilar artery occlusion, shorter procedure time during endovascular treatment is associated with favorable outcome, regardless of collateral circulation. Registration URL: https://www.clinicaltrials.gov; Unique Identifier: NCT04751708.https://www.ahajournals.org/doi/10.1161/JAHA.124.038271angiographybasilar artery occlusioncollateral circulationcomputed tomographyprognosis |
| spellingShingle | Cong Luo Rui Li Chunrong Tao Ming Cai Lang Chen Peng Hao Xinfeng Liu Wei Hu The Basilar Artery Collateral Simplified Score: a Novel Collateral Circulation Score Associated With Outcomes in Patients With Basilar Artery Occlusion: Results From the ATTENTION Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease angiography basilar artery occlusion collateral circulation computed tomography prognosis |
| title | The Basilar Artery Collateral Simplified Score: a Novel Collateral Circulation Score Associated With Outcomes in Patients With Basilar Artery Occlusion: Results From the ATTENTION Study |
| title_full | The Basilar Artery Collateral Simplified Score: a Novel Collateral Circulation Score Associated With Outcomes in Patients With Basilar Artery Occlusion: Results From the ATTENTION Study |
| title_fullStr | The Basilar Artery Collateral Simplified Score: a Novel Collateral Circulation Score Associated With Outcomes in Patients With Basilar Artery Occlusion: Results From the ATTENTION Study |
| title_full_unstemmed | The Basilar Artery Collateral Simplified Score: a Novel Collateral Circulation Score Associated With Outcomes in Patients With Basilar Artery Occlusion: Results From the ATTENTION Study |
| title_short | The Basilar Artery Collateral Simplified Score: a Novel Collateral Circulation Score Associated With Outcomes in Patients With Basilar Artery Occlusion: Results From the ATTENTION Study |
| title_sort | basilar artery collateral simplified score a novel collateral circulation score associated with outcomes in patients with basilar artery occlusion results from the attention study |
| topic | angiography basilar artery occlusion collateral circulation computed tomography prognosis |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.038271 |
| work_keys_str_mv | AT congluo thebasilararterycollateralsimplifiedscoreanovelcollateralcirculationscoreassociatedwithoutcomesinpatientswithbasilararteryocclusionresultsfromtheattentionstudy AT ruili thebasilararterycollateralsimplifiedscoreanovelcollateralcirculationscoreassociatedwithoutcomesinpatientswithbasilararteryocclusionresultsfromtheattentionstudy AT chunrongtao thebasilararterycollateralsimplifiedscoreanovelcollateralcirculationscoreassociatedwithoutcomesinpatientswithbasilararteryocclusionresultsfromtheattentionstudy AT mingcai thebasilararterycollateralsimplifiedscoreanovelcollateralcirculationscoreassociatedwithoutcomesinpatientswithbasilararteryocclusionresultsfromtheattentionstudy AT langchen thebasilararterycollateralsimplifiedscoreanovelcollateralcirculationscoreassociatedwithoutcomesinpatientswithbasilararteryocclusionresultsfromtheattentionstudy AT penghao thebasilararterycollateralsimplifiedscoreanovelcollateralcirculationscoreassociatedwithoutcomesinpatientswithbasilararteryocclusionresultsfromtheattentionstudy AT xinfengliu thebasilararterycollateralsimplifiedscoreanovelcollateralcirculationscoreassociatedwithoutcomesinpatientswithbasilararteryocclusionresultsfromtheattentionstudy AT weihu thebasilararterycollateralsimplifiedscoreanovelcollateralcirculationscoreassociatedwithoutcomesinpatientswithbasilararteryocclusionresultsfromtheattentionstudy AT congluo basilararterycollateralsimplifiedscoreanovelcollateralcirculationscoreassociatedwithoutcomesinpatientswithbasilararteryocclusionresultsfromtheattentionstudy AT ruili basilararterycollateralsimplifiedscoreanovelcollateralcirculationscoreassociatedwithoutcomesinpatientswithbasilararteryocclusionresultsfromtheattentionstudy AT chunrongtao basilararterycollateralsimplifiedscoreanovelcollateralcirculationscoreassociatedwithoutcomesinpatientswithbasilararteryocclusionresultsfromtheattentionstudy AT mingcai basilararterycollateralsimplifiedscoreanovelcollateralcirculationscoreassociatedwithoutcomesinpatientswithbasilararteryocclusionresultsfromtheattentionstudy AT langchen basilararterycollateralsimplifiedscoreanovelcollateralcirculationscoreassociatedwithoutcomesinpatientswithbasilararteryocclusionresultsfromtheattentionstudy AT penghao basilararterycollateralsimplifiedscoreanovelcollateralcirculationscoreassociatedwithoutcomesinpatientswithbasilararteryocclusionresultsfromtheattentionstudy AT xinfengliu basilararterycollateralsimplifiedscoreanovelcollateralcirculationscoreassociatedwithoutcomesinpatientswithbasilararteryocclusionresultsfromtheattentionstudy AT weihu basilararterycollateralsimplifiedscoreanovelcollateralcirculationscoreassociatedwithoutcomesinpatientswithbasilararteryocclusionresultsfromtheattentionstudy |