Significance of angiographic clot meniscus sign in mechanical thrombectomy of basilar artery stroke

Sung Hyun Baik, Joon Whi Kim, Byung Moon Kim, Dong Joon Kim

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13 Citations (Scopus)


Introduction The relationship between the occlusive clot morphology and the efficacy of mechanical thrombectomy (MT) in basilar artery occlusion (BAO) is not well known. Our aim was to evaluate the clinical significance of the clot meniscus sign in patients with acute BAO. Methods 89 patients with acute BAO who underwent MT were retrospectively analyzed. The clot meniscus sign was defined as meniscoid/tram-track like antegrade side-wall contrast opacification of the thrombus. Patients were assigned to two groups based on the presence of the clot meniscus sign. The treatment and clinical outcomes were compared. Results The clot meniscus sign was diagnosed in 62.9% (53/89) of the patients. The meniscus sign (+) group showed a shorter procedure time (55 vs 85 min; p=0.045), higher rate of successful recanalization (89.3% vs 63.6%, p=0.004), higher incidence of first pass effect (32.1% vs 6.1%, p=0.004), and lower number of passes (2 vs 3; p=0.042) when compared with the meniscus sign (-) group. The procedure time (OR 0.972, 95% CI 0.962 to 0.992; p=0.003) and clot meniscus sign (OR 7.920, 95% CI 1.769 to 35.452; p=0.007) were independent predictors of successful recanalization. Conclusion The clot meniscus sign is related to high first pass effect and short procedure time and is a reliable predictor of successful recanalization in patients with acute BAO.

Original languageEnglish
Pages (from-to)477-482
Number of pages6
JournalJournal of NeuroInterventional Surgery
Issue number5
Publication statusPublished - 2020 May 1

Bibliographical note

Funding Information:
Supported by the Research Institute of Radiological Science, Yonsei University College of Medicine (grant 4-2017-0672).

Funding Information:
Funding supported by the research institute of radiological science, Yonsei University college of Medicine (grant 4-2017-0672).

Publisher Copyright:
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology


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