{
  "abstract": "Background: Basilar artery occlusion (BAO) is a devastating subtype of stroke with poor prognosis. Current patient selection tools for endovascular thrombectomy (EVT) are multi-tiered with interrater variability and limited validation studies. The HALF-IT score is a novel, simplified, dichotomized triaging tool focusing solely on the brainstem level. This study investigated the utility of the HALF-IT score to predict functional outcomes of EVT in patients with BAO.\n\nMethods: We conducted a multicenter, retrospective, cohort study including patients with acute BAO presenting to four comprehensive stroke centers between 2021–2025. Acute infarction of ≥50% of any brainstem section on any axial or coronal slice of MRI was considered HALF-IT positive, whereas < 50% was considered HALF-IT negative. The primary efficacy outcome was a favorable functional outcome, defined as a modified Rankin Scale (mRS) score of 0–3 at 90 days; functional independence (mRS 0–2) was analyzed as a secondary outcome. Reperfusion was graded with the modified Thrombolysis in Cerebral Infarction (mTICI) scale. Primary safety endpoints included symptomatic intracranial hemorrhage at 24 h and all-cause mortality at 90 days. Multivariable logistic regression was performed to identify independent predictors of the primary efficacy outcome.\n\nResults: 37 patients (23 HALF-IT negative; 14 HALF-IT positive) met the inclusion criteria. The rate of 90-day mRS 0–3 was significantly lower in the HALF-IT positive compared with HALF-IT negative group [14.3% vs. 68.2%, OR 0.08 (0.01–0.45), p = 0.004]. HALF-IT positive status remained associated with a lower rate of 90-day mRS 0–3 after adjusting for age, initial NIHSS, onset-to-reperfusion time, intravenous thrombolysis administration complete reperfusion (final mTICI 3) [adjusted OR 0.02, 95% CI 0–0.84, p = 0.02]. Safety events were numerically higher in the HALF-IT positive group but the difference did not reach statistical significance. The two groups differed substantially at baseline in age, presenting NIHSS, and intravenous thrombolysis exposure, whereas stroke etiology ( p = 0.28) and level of basilar occlusion ( p = 0.63) were similarly distributed.\n\nConclusion: In this small, retrospective, hypothesis-generating cohort, HALF-IT positivity was associated with worse 90-day functional outcomes after EVT for BAO. Further prospective validation in larger cohorts is required before the score can inform treatment decisions.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Vascular and Endovascular Neurology, Indiana University School of Medicine",
    "Department of Neuroscience, Bon Secours Mercy Health St. Vincent Hospital",
    "Department of Neuroendovascular Surgery, Ochsner Clinic Foundation Lafayette General Hospital",
    "Department of Neuroendovascular Surgery, HCA Houston Healthcare Kingwood",
    "Department of Vascular and Endovascular Neurology, University of California"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 14,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ann Marie Jones"
    },
    {
      "affs": [
        1
      ],
      "name": "Zain Tariq"
    },
    {
      "affs": [
        1
      ],
      "name": "Yazan Ashouri"
    },
    {
      "affs": [
        1
      ],
      "name": "Amit Chaudhari"
    },
    {
      "affs": [
        2
      ],
      "name": "Mohammad AlMajali"
    },
    {
      "affs": [
        3
      ],
      "name": "Mohamad Ezzeldin"
    },
    {
      "affs": [
        1
      ],
      "name": "Mustafa Abdul Kareem"
    },
    {
      "affs": [
        1
      ],
      "name": "Ahmad R. Awwad"
    },
    {
      "affs": [
        4
      ],
      "name": "Gregory Wong"
    },
    {
      "affs": [
        4
      ],
      "name": "Amir M. Molaie"
    },
    {
      "affs": [
        4
      ],
      "name": "Borja Sanz Cuesta"
    },
    {
      "affs": [
        4
      ],
      "name": "Jeffrey L. Saver"
    },
    {
      "affs": [
        0
      ],
      "name": "Kaustubh Limaye"
    },
    {
      "affs": [
        1
      ],
      "name": "Osama O. Zaidat"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/dh739wwfgsksv.bib",
  "cited_by": 0,
  "doi": "10.3389/fneur.2026.1915436",
  "fulltext_url": "https://europepmc.org/articles/PMC13713328",
  "id": "dh739wwfgsksv",
  "issns": [
    "1664-2295"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fneur.2026.1915436/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2713|Acute Ischemic Stroke Management"
    ]
  ],
  "openalex": "W7221795459",
  "pdf_url": "https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2026.1915436/pdf",
  "pmcid": "PMC13713328",
  "pmid": "42952507",
  "published": "2026-10-14",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/dh739wwfgsksv.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:16Z",
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      "url": "https://www.frontiersin.org/articles/10.3389/fneur.2026.1915436/full"
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      "first_seen": "2026-10-31T00:20:34Z",
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Acute Ischemic Stroke Management",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "The HALF-IT score: proposing a simplified mechanical thrombectomy triage tool for basilar artery occlusion",
  "title_text": "The HALF-IT score: proposing a simplified mechanical thrombectomy triage tool for basilar artery occlusion",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T12:21:01Z",
  "url": "https://research.draconitic.com/paper/dh739wwfgsksv",
  "venue": "Frontiers in Neurology",
  "versions": []
}