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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Korean+Neurosurg+Soc
2017 ; 60
(6
): 635-643
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English Wikipedia
Effectiveness and Safety of Mechanical Thrombectomy with Stent Retrievers in
Basilar Artery Occlusion: Comparison with Anterior Circulation Occlusions
#MMPMID29142622
Hu SY
; Yi HJ
; Lee DH
; Hong JT
; Sung JH
; Lee SW
J Korean Neurosurg Soc
2017[Nov]; 60
(6
): 635-643
PMID29142622
show ga
OBJECTIVE: Acute basilar artery occlusion (BAO) is associated with severe
neurological dysfunction and high mortality rates. The benefits of mechanical
thrombectomy in BAO have not been explored in recent clinical trials. Therefore,
we analyzed outcomes of stent retriever mechanical thrombectomy for BAO, and
compared with anterior circulation occlusions (ACO). METHODS: In total, 161
consecutive patients (24 BAO, 137 ACO) who underwent mechanical thrombectomy with
the stent retriever between January 2013 and August 2016 enrolled in our study.
All patients underwent clinical assessment with the National Institutes of Health
Stroke Scale (NIHSS) and modified Rankin scale (mRS). Radiological results were
used to evaluate thrombolysis in cerebral infarction (TICI) scores and successful
recanalization was defined by TICI 2b or 3. RESULTS: Mean NIHSS scores at 24
hours and 30 days were significantly higher in the BAO group than the ACO group
(p=0.021, p=0.001). mRS at 90 days was significantly higher in the BAO group
(4.2) compared with the ACO group (3.0) (p=0.003). The BAO group (2.0) performed
fewer stent retriever passages than the ACO group (2.7) (p=0.049). There were no
significant differences between the two groups in terms of complications, but the
BAO patients experienced a higher mortality (16.6%) rate than ACO patients (5.8%)
(p=0.001). In subgroup analysis of BAO, patients with short procedure times
achieved successful recanalization (p=0.001) and successfully recanalized
patients exhibited more favorable mRS at 90 days (p=0.027). CONCLUSION: In our
study, mechanical thrombectomy of BAO patients showed worse clinical outcome and
higher mortality rate than ACO patients. However, mechanical thrombectomy with a
stent retriever in BAO is an effective treatment, because successfully
recanalized patients showed good clinical outcome in BAO patients.