Implications of Mechanical Endovascular Thrombectomy for Acute Basilar and Posterior Cerebral Artery Occlusion.
10.7461/jcen.2018.20.3.168
- Author:
Hyun Nyung LEE
1
;
Bum Tea KIM
;
Soo Bin IM
;
Sun Chul HWANG
;
Je Hoon JEONG
;
Moon Young CHUNG
;
Jong Hyun PARK
;
Dong Seong SHIN
Author Information
1. Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea. sch.shin.ds@gmail.com
- Publication Type:Original Article
- Keywords:
Ischemic stroke;
Mechanical thrombectomy;
Basilar artery occlusion;
Endovascular treatment
- MeSH:
Arteries;
Basilar Artery;
Catheters;
Early Diagnosis;
Humans;
Medical Records;
Passive Cutaneous Anaphylaxis;
Posterior Cerebral Artery*;
Stents;
Stroke;
Thrombectomy*;
Tissue Plasminogen Activator
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2018;20(3):168-175
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Protocols for posterior circulation ischemic stroke have not been established by randomized clinical trials. Mechanical endovascular thrombectomy (MET) devices are evolving, and many of these devices already developed or in development are suitable for posterior circulation MET. MATERIALS AND METHODS: We investigated the medical records of patients who underwent MET for posterior circulation ischemic stroke from January 2012 to August 2016. Fifteen patients were included. MET was performed in patients with or without injected intravenous tissue plasminogen activator. MET was considered in patients with a National Institute of Health Stroke Scale score of 4 or more, older than 18 years, with definite occlusion of the basilar artery or posterior cerebral artery (PCA), and who arrived at the hospital within 24 hours from onset. RESULTS: The direct catheter aspiration technique was used in five cases, and the stent retrieval technique was used in seven cases. The stent retrieval technique with the direct aspiration technique was used in three cases. Recanalization failed in two cases. Basilar occlusion without PCA involvement is the only effective factor of successful recanalization (p = 0.03). Successful recanalization (p = 0.005) and the presence of a posterior communicating artery (p = 0.005) affected the good outcome at discharge. CONCLUSION: An early diagnosis and active MET may improve the patient outcome. MET may help recanalization and good flow restoration and the potential for a good outcome.
