Background Acute vertebrobasilar artery occlusion is associated with mortality rates up to 80%. While endovascular thrombectomy has proven effective, patient selection remains challenging due to limited validated prediction models. This study aimed to develop and externally validate a nomogram for predicting 90‐day excellent functional outcome (modified Rankin Scale score, 0–1) in patients with acute vertebrobasilar artery occlusion undergoing endovascular thrombectomy. Methods A total of 819 patients with vertebrobasilar artery occlusion undergoing endovascular thrombectomy were enrolled in this study. Of these, 242 patients from 4 stroke centers were allocated to the training cohort, while 577 patients from the PERSIST (Posterior Circulation Ischemic Stroke) registry comprised the validation cohort. Multivariate logistic regression identified independent predictors for nomogram development. Model performance was assessed using the concordance index, calibration curves, and decision curve analysis. Results The overall excellent outcome rate was 21.2%, with 85.1% achieving successful recanalization. Five independent predictors were identified: age 6 ( OR, 1.34; P =0.028), and successful recanalization ( OR, 4.49; P =0.019). The nomogram demonstrated excellent discriminative performance, with a concordance index of 0.82 in the training cohort and 0.92 in external validation. Good calibration was confirmed (Hosmer–Lemeshow test, P =0.514). Conclusions We developed and externally validated a practical nomogram incorporating 5 clinical variables for predicting excellent outcomes in patients with acute vertebrobasilar artery occlusion undergoing endovascular thrombectomy. The model demonstrates robust performance and clinical utility, providing valuable support for evidence‐based decision making in posterior circulation stroke management.
Pan et al. (Fri,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: