{
  "abstract": "Purpose Landmark trials (ATTENTION, BAOCHE) established endovascular thrombectomy (EVT) for basilar artery occlusion (BAO), but all positive randomized evidence derives from East Asian cohorts. Real-world data from the Middle East and North Africa (MENA) region are absent. We evaluated BAO thrombectomy outcomes in the MENA region, with emphasis on the prognostic role of baseline PC-ASPECTS and the rate of futile recanalization in patients with unfavorable imaging profiles.Methods From the MEMENTO registry, 105 consecutive BAO thrombectomy patients across 15 centers (2022-2024) were stratified into favorable PC-ASPECTS (≥6, n=80) and unfavorable PC-ASPECTS (<6, n=25) groups. The primary outcome was favorable functional status (mRS 0-3) at 90 days. Secondary outcomes included functional independence (mRS 0-2), recanalization (TICI≥2b), sICH, and 90-day mortality. Bayesian analysis supplemented frequentist testing.Results Among 105 patients (median age 65, 63% male, median NIHSS 18), successful recanalization was achieved in 84 (80.0%). Favorable outcome at 90 days occurred in 44 patients (41.9%), with significant disparity between PC-ASPECTS groups: 50.0% (40/80) in the favorable group versus 16.0% (4/25) in the unfavorable group (p=0.002). Functional independence was 27.6% overall (32.5% vs. 12.0%, p=0.041). Ninety-day mortality was 34.3% overall, significantly higher in the unfavorable group (64.0% vs. 25.0%, p<0.001). Among successfully recanalized unfavorable PC-ASPECTS patients, futile recanalization occurred in 78.9% (15/19). Intracranial atherosclerotic disease (ICAD) was identified in 35 patients (33.3%); final recanalization was comparable between ICAD and non-ICAD patients after rescue therapy (77% vs. 81%, p=0.48). BATMAN score ≥7 independently predicted favorable outcome (aOR 2.87, 95% CI 1.24-6.64).Conclusions Real-world BAO thrombectomy in the MENA region achieves outcomes comparable to landmark trials. PC-ASPECTS <6 identifies a subgroup with profoundly poor outcomes despite successful recanalization. ICAD prevalence is high but manageable with rescue intracranial therapy.Disclosures O. Mansour: None. A. ozdimair: None. S. Irteza: None. F. hassan: None. A. Abdulrahman: None. F. Alghamdi: None. I. Alnaami: None. N. Hammami: None. T. Hassan: None.Abstract E-320 Figure 1",
  "authors": [
    {
      "affiliations": [
        "Neurology, Stroke and Neurointervention Center, Alexandria, Egypt"
      ],
      "name": "O Mansour"
    },
    {
      "affiliations": [
        "Neurology, Eskisehir Osmangazi University, Eskisehir, Turkey"
      ],
      "name": "A Ozdimair"
    },
    {
      "affiliations": [
        "Neurology, Stroke and Neurointervention Center, Abu Dhabi, United Arab Emirates"
      ],
      "name": "S Irteza"
    },
    {
      "affiliations": [
        "Interventional neuroradiology, cairo univeristy, cairo, Egypt"
      ],
      "name": "F Hassan"
    },
    {
      "affiliations": [
        "Neuroradiology, King Abdulaziz Medical City, Jeddah, Saudi Arabia, Jeddah, Saudi Arabia"
      ],
      "name": "A Abdulrahman"
    },
    {
      "affiliations": [
        "Neuroradiology, King Abdullah Medical City, Makkah, Saudi Arabia, Makkah, Saudi Arabia"
      ],
      "name": "F Alghamdi"
    },
    {
      "affiliations": [
        "Neurosurgery, King Khalid University, Abha, Saudi Arabia, Abha, Saudi Arabia"
      ],
      "name": "I Alnaami"
    },
    {
      "affiliations": [
        "Neuroradiology, Institut National de Neurologie, Tunis, Tunisia, Tunis, Tunisia"
      ],
      "name": "N Hammami"
    },
    {
      "affiliations": [
        "Neurosurgery, Stroke and Neurointervention Center, Alexandria, Egypt"
      ],
      "name": "T Hassan"
    }
  ],
  "title": "E-320 Real-world basilar artery thrombectomy in the MENA region: PC-ASPECTS stratification identifies futile recanalization in the MEMENTO registry",
  "uid": "70641a68-57a9-51a6-9998-820c16b3d453"
}