Preferred thrombectomy strategies for acute embolic occlusion of the vertebrobasilar artery: a comparative study
10.3760/cma.j.cn115354-20220823-00581
- VernacularTitle:栓塞性急性椎基底动脉闭塞首选取栓策略的比较研究
- Author:
Ning WANG
1
;
Changming WEN
;
Jun GAO
;
Yifeng LIU
;
Jun SUN
;
Zaihang ZHANG
;
Donghuan ZHANG
;
Shuang PEI
;
Yinxue YANG
Author Information
1. 南阳市中心医院神经内科，南阳 473000
- Keywords:
Embolism;
Vertebrobasilar artery;
Posterior circulation;
Cerebral infarction;
Mechanical thrombectomy;
Aspiration thrombectomy
- From:
Chinese Journal of Neuromedicine
2022;21(12):1226-1231
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of different preferred thrombectomy strategies for embolic acute vertebrobasilar artery occlusion (AVBAO).Methods:Forty-four patients with embolic AVBAO who underwent endovascular treatment in Department of Neurology, Nanyang Central Hospital from January 2019 to June 2021 were included in the study. Patients were divided into stent-retriever thrombectomy group ( n=27) and aspiration thrombectomy group ( n=17) according to different preferred thrombectomy strategies. Modified Rankin scale (mRS) was used to evaluate the prognoses of these patients 90 d after surgery; the differences of clinical data, surgery-related characteristics, prognoses and complications between the two groups were compared. Results:There was no significant difference between the 2 groups in terms of time from onset to puncture, sites of target vessel occlusion, proportion of patients accepted intraoperative remedial measures, and successful recirculation rate of target vessels ( P>0.05). Compared with the aspiration thrombectomy group, the stent-retriever thrombectomy group had significantly decreased utilization rate of middle catheters, significantly increased retrieval attempts in thrombectomy, statistically lower re-recanalization rate of first-time thrombectomy on the target vessels, significantly longer time from puncture to re-recanalization, and significantly higher incidence of new embolism ( P<0.05). There was no significant difference between the 2 groups in incidences of vascular rupture and postoperative spontaneous intracerebral hemorrhage (sICH), and good prognosis rate 90 d after surgery ( P>0.05). Conclusion:For embolic AVBAO patients, similar recanalization and short-term good prognosis can be obtained by aspiration thrombectomy to those by stent-retriever thrombectomy; besides that, aspiration thrombectomy has advantages as shorter recanalization time, less new embolic complications and higher re-recanalization rate of first-time thrombectomy.
