Strategies of endovascular recanalization in acute vertebrobasilar artery occlusion of different lesion sites: a comparative analysis
10.3760/cma.j.cn115354-20210909-00587
- VernacularTitle:急性椎基底动脉闭塞不同病变部位血管内开通策略的比较研究
- Author:
Lina WANG
1
;
Yanghui LIU
;
Liangfu ZHU
;
Ying XING
;
Zhilong ZHOU
;
Zhenkai MA
;
Tengfei ZHOU
;
Liheng WU
;
Ming GUAN
;
Qiang LI
;
Yang ZHANG
;
Tianxiao LI
Author Information
1. 郑州大学人民医院，河南省人民医院脑血管病科，国家高级卒中中心，郑州 450003
- Keywords:
Vertebral basilar artery;
Endovascular treatment;
Thrombolysis;
Recanalization strategy
- From:
Chinese Journal of Neuromedicine
2022;21(1):13-19
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the pathogenesis, selection of endovascular treatment (EVT) strategies, and efficacies of acute vertebrobasilar artery occlusion (AVBAO) of different lesion sites.Methods:One hundred and five patients with AVBAO, admitted to and accepted EVT in our hospital from February 2017 to September 2019, were chosen in our study. The data of disease onset, imaging findings, EVT status, perioperative complications, and prognoses of these patients were collected. According to DSA results, the involved lesions were divided into 4 sites: the upper segment of basilar artery (BA), the middle segment of BA, the lower segment of BA, and the intracranial segment of vertebral artery (V4 segment), and patients with tandem lesions would be recorded as distal lesions. The risk factors, EVT strategies, and prognoses 90 d after follow-up (modified Rankin scale [mRS] scores≤3: good prognosis) were compared in patients with 4 different lesion sites.Results:There were significant differences in etiological classifications and percentage of patients combined with atrial fibrillation among patients with 4 different lesion sites ( P<0.05). There was significant difference in proportion of patients accepted emergency stent implantation among patients with 4 different lesion sites ( P<0.05): those with lesions at the V4 segment had the highest proportion of patients accepted emergency stent implantation (79.55%), followed by those with lesions at the lower segment of BA (50.00%). There was significant difference in EVT time (the time from arterial puncture to successful recanalization of occluded vessels) among patients with 4 different lesion sites ( P<0.05): the EVT time in patients with lesions at the middle segment of BA was the shortest (87.5 [58.5, 130.8] min), and the EVT time in patients with lesions at the lower segment of BA was the longest (115.0 [81.0, 163.0] min). There was no statistical difference among patients with different lesion sites in good prognosis rate 90 d after follow-up ( P>0.05). Conclusion:The pathogenesis of patients with different AVBAO lesion sites is different, so different EVT strategies should be adopted.
