Prognostic Implications of Post-Endovascular Therapy Contrast Staining in Basilar Artery Occlusion Stroke - Report - MDSpire

Prognostic Implications of Post-Endovascular Therapy Contrast Staining in Basilar Artery Occlusion Stroke

  • By

  • Natascha Hohmann

  • Matthias P. Fabritius

  • Sijing Gu

  • Daniel Puhr-Westerheide

  • Philipp Lohse

  • Steffen Tiedt

  • Lars Kellert

  • Konstantinos Dimitriadis

  • Sergio Grosu

  • Thomas Liebig

  • Jens Ricke

  • Wolfgang G. Kunz

  • Osman Öcal

  • Paul Reidler

  • April 28, 2026

  • 0 min

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Clinical Report: Prognostic Implications of Post-Endovascular Therapy Contrast Staining in Basilar Artery Occlusion Stroke

Overview

This study evaluates the prognostic significance of contrast staining on post-interventional CT in patients with basilar artery occlusion (BAO) stroke after endovascular therapy (EVT). Findings indicate that contrast staining is a strong predictor of unfavorable functional outcomes at 90 days.

Background

Basilar artery occlusion (BAO) stroke is a critical condition associated with high morbidity and mortality. Endovascular therapy (EVT) has become the standard treatment for BAO, yet patient outcomes can vary significantly. Understanding imaging biomarkers like contrast staining can aid in predicting functional outcomes and improving patient management.

Data Highlights

ParameterValue
Patients with contrast staining18 (42.9%)
Median contrast staining volume (mL)7.9 [3.7–14.6]
Median mRS score at 90 days (with contrast staining)6 [4–6]
Median mRS score at 90 days (without contrast staining)2 [1–4]
p-value for mRS score difference< 0.001

Key Findings

  • Contrast staining was observed in 42.9% of patients post-EVT.
  • Patients with contrast staining had significantly higher mRS scores at 90 days compared to those without.
  • The median volume of contrast staining was 7.9 mL.
  • Contrast staining was identified as a strong predictor of unfavorable functional outcomes.
  • The study utilized multivariable LASSO analysis to assess the association between contrast staining and clinical outcomes.

Clinical Implications

The presence of contrast staining on post-interventional CT can serve as a critical imaging biomarker for predicting functional outcomes in BAO stroke patients. Clinicians should consider this parameter when evaluating prognosis and tailoring post-EVT management strategies.

Conclusion

Contrast staining on post-interventional CT is a significant predictor of unfavorable outcomes in BAO stroke patients treated with EVT. This finding underscores the importance of imaging in clinical decision-making.

References

  1. European Radiology, 2024 -- Influence of Ischemic Stroke Location on Early Outcomes in Basilar Artery Occlusion: A Retrospective Analysis
  2. European Radiology, 2025 -- Endovascular Recanalization with Distal Protection for Symptomatic Chronic Occlusions of the Vertebrobasilar Artery
  3. European Radiology, 2023 -- Collateral Mapping: Forecasting Lesion Expansion and Penumbral Area Following Acute Anterior Circulation Ischemic Stroke
  4. 2026 Guideline for the Early Management of Patients With AIS - Professional Heart Daily | American Heart Association
  5. JAMA Neurology, 2023 -- Endovascular vs Medical Management of Acute Basilar Artery Occlusion: A Secondary Analysis of a Randomized Clinical Trial
  6. European Radiology — Hemodynamic Characteristics from Angiography as Predictors of Recurrent Ischemic Events Following Angioplasty and Stenting for Intracranial Vertebrobasilar Atherosclerotic Stenosis
  7. 2026 Guideline for the Early Management of Patients With AIS - Professional Heart Daily | American Heart Association
  8. Endovascular vs Medical Management of Acute Basilar Artery Occlusion: A Secondary Analysis of a Randomized Clinical Trial | Trials | JAMA Neurology | JAMA Network
  9. Frontiers | Diagnostic performance of dual-energy CT for differentiating acute intracranial hemorrhage from contrast staining: a systematic review and meta-analysis

Original Source(s)

Prognostic Implications of Post-Endovascular Therapy Contrast Staining in Basilar Artery Occlusion Stroke

  • by Natascha Hohmann, Matthias P. Fabritius, Sijing Gu, Daniel Puhr-Westerheide, Philipp Lohse, Steffen Tiedt, Lars Kellert, Konstantinos Dimitriadis, Sergio Grosu, Thomas Liebig, Jens Ricke, Wolfgang G. Kunz, Osman Öcal, Paul Reidler

  • April 28, 2026

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