The Basilar Artery on Computed Tomography Angiography Score for Acute Basilar Artery Occlusion Treated with Mechanical Thrombectomy

Background: Recently, the Basilar Artery on Computed Tomography Angiography (BATMAN) score predicts clinical outcome of acute basilar artery occlusion (BAO), yet there is no extensive external validation. The purpose of this study was to validate the prognostic value of BATMAN scoring system for the prediction of clinical outcome in patients with acute BAO treated with endovascular mechanical thrombectomy by using cerebral digital subtraction angiography (DSA). Methods: We analyzed the clinical and angiographic data of consecutive patients with acute BAO from March 2012 to November 2016. The BATMAN scoring system was used to assess the collateral status and thrombus burden. Thrombolysis in Cerebral Infarction (TICI) score 2b-3 was defined as successful recanalization. Receiver operating characteristic (ROC) curve was used to determine the area under the curve (AUC) and the optimum cutoff value. Multivariate regression analysis was used to identify the predictor of clinical outcome. Results: This study included 63 patients with acute BAO who underwent mechanical thrombectomy. Of these patients, 90.5% (57/63) achieved successful recanalization (TICI, 2b-3) and 34.9% (22/63) had a favorable outcome (modified Rankin Scale score 0-2). ROC analysis indicated that the AUC of the BATMAN score was .722 (95% confidence interval [CI], .594-.827), and the optimal cutoff value was 3 (sensitivity = 72.73, specificity = 63.41). In multivariate logistic regression analysis, the BATMAN score higher than 3 was associated with favorable outcome (odds ratio, 5.214; 95% CI, 1.47-18.483; P =.011). Conclusions: The BATMAN score on DSA seems to predict the functional outcome in patients of acute BAO treated with mechanical thrombectomy.