Intraarterial Thrombolysis and Stent Placement for Acute Basilar Artery Occlusion

2010 ◽  
Vol 21 (9) ◽  
pp. 1359-1363 ◽  
Author(s):  
Yao-Yu Yu ◽  
Le Niu ◽  
Li Gao ◽  
Zhen-Wei Zhao ◽  
Jian-Ping Deng ◽  
...  
Keyword(s):  
Basilar Artery ◽  
Stent Placement ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion ◽  
Intraarterial Thrombolysis

scholarly journals Safety and Efficacy of Direct Angioplasty in Acute Basilar Artery Occlusion Due to Atherosclerosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Gaoting Ma ◽  
Xuan Sun ◽  
Xu Tong ◽  
Baixue Jia ◽  
Xiaochuan Huo ◽  
...  
Keyword(s):  
Basilar Artery ◽  
Stent Placement ◽  
Functional Independence ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion ◽  
Procedure Time ◽  
Laboratory Findings ◽  
Safety And Efficacy ◽  
Intracranial Atherosclerotic Disease ◽  
Rescue Treatment

Background and Purpose: Endovascular treatment (EVT) is one of the promising treatment options in patients with intracranial atherosclerotic disease (ICAD)-related basilar artery occlusion (BAO). In this study, we compared the safety and efficacy of direct angioplasty (DA) with stent-retriever thrombectomy (SRT) with or without rescue treatment in ICAD-related BAO.Methods: We retrospectively evaluated 187 patients who underwent EVT for BAO from January 2012 to July 2018. We identified patients who underwent EVT due to ICAD-related BAO. Patients who accepted SRT with or without rescue treatment were classified into the SRT group. Patients treated with DA with or without stent placement were classified into DA group. Clinical and laboratory findings and outcomes were compared between groups.Results: A total of 108 patients were enrolled, among them 77 underwent SRT and 31 underwent DA; 61 (79.2%) SRT group patients underwent angioplasty with or without stent placement. Compared with patients in the SRT group, those in the DA group experienced a significantly shorter procedure time [60 min (60–120 min) vs. 120 min (60–120 min); p = 0.038] and a lower number of device passes [2 passes (1–2 passes) vs. 3 passes (2–4 passes); p < 0.001]. No significant differences in balloon angioplasty (35.5 vs. 22.1%; p = 0.150), emergent stent placement (64.5 vs. 57.1%; p = 0.481), successful recanalization (93.5 vs. 85.7%; p = 0.340), embolization in distal or new territory (3.2 vs. 9.1%, p = 0.314), and reocclusion (22.6 vs. 9.1%; p = 0.109) among DA and SRT groups were found. Additionally, no differences in symptomatic intracranial hemorrhage incidence [adjusted odds ratio (OR), 0.74; 95% CI, 0.06–9.44; p = 0.815], functional independence (adjusted OR, 1.44; 95% CI, 0.50–4.16; p = 0.497), and mortality rate (adjusted OR, 0.36; 95% CI, 0.06–2.04; p = 0.247) were noted among groups.Conclusions: In certain patients with ICAD-related BAO, DA may shorten procedure time and reduce required device passes compared to SRT. In this study, DA was retrospectively found to be of similar safety and efficacy as SRT.

scholarly journals Endovascular Management in Patients with Acute Basilar Artery Obstruction: Low-Dose Intra-Arterial Urokinase and Mechanical Clot Disruption

2011 ◽  
Vol 17 (4) ◽  
pp. 435-441
Author(s):  
J.S. Yun ◽  
H.S. Kwak ◽  
S.B. Hwang ◽  
G.H. Chung
Keyword(s):  
Median Time ◽  
Basilar Artery ◽  
Symptom Onset ◽  
Stent Placement ◽  
Low Dose ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion ◽  
Interventional Treatment ◽  
Nihss Score ◽  
Clot Disruption

Mechanical clot disruption for the treatment of acute basilar artery occlusion (BAO) is known to provide a benefit. We aimed to determine the safety, recanalization rate and time-to-flow restoration of mechanical clot disruption and low dose urokinase (UK) infusions for the treatment of patients with acute BAO. Between June 2006 and June 2010, 21 patients with acute BAO underwent endovascular treatment that included angioplasty or stent placement. The time to treatment, duration of the procedure, dose of urokinase (UK), recanalization rates and symptomatic hemorrhages were analyzed. Clinical outcome measures were assessed at admission and at the time of discharge using the National Institutes of Health Stroke Scale (NIHSS) score and at three months after treatment using the modified Rankin Score (mRS). On admission, the median NIHSS score was 13.2. Median time from symptom onset to arrival at hospital was 356 minutes, and median time from symptom onset to intraarterial thrombolysis (IAT) was 49 minutes. We used the following interventional treatment regimens: Intraarterial (IA) UK and a minimal mechanical procedure (n=14), IA UK with angioplasty (n=1), IA UK with angioplasty and stent placement (n=3) and IA UK with HyperForm (n=3). The recanalization (thrombolysis in cerebral ischemia grade II or III) rate was 90.5% (19/21). There was symptomatic hemorrhage in one patient (4.8%). The median NIHSS score at discharge was 6.3. The three-month outcome was favorable (mRS: 0–2) for 14 patients (66.7%) and poor (mRS: 3–6) for seven patients (33.3%). The overall mortality at three months was 14.3% (three patients died). Low-dose IAT with mechanical clot disruption is a safe and effective treatment for treatment for acute BAO.

Endovascular Treatment for Acute Basilar Artery Occlusion: A Nationwide Prospective Registry

2019 ◽  
Author(s):  
Wenjie Zi ◽  
Zhongming Qiu ◽  
Deping Wu ◽  
Fengli Li ◽  
Hansheng Liu ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Basilar Artery ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion

Late recanalization of basilar artery occlusion in a previously healthy 17-month-old child

2017 ◽  
pp. bcr-2017-013277
Author(s):  
D Andrew Wilkinson ◽  
Aditya S Pandey ◽  
Hugh J Garton ◽  
Luis Savastano ◽  
Julius Griauzde ◽  
...  
Keyword(s):  
Basilar Artery ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion

Isolated basilar artery occlusion by parietal dissection after severe chest and minor head trauma

1998 ◽  
Vol 16 (6) ◽  
pp. 614-616 ◽  
Author(s):  
Massimo Gallerani ◽  
Vanni Veronesi ◽  
Stefano Ceruti ◽  
Giorgio Mantovani ◽  
Reza Ghadirpour
Keyword(s):  
Head Trauma ◽  
Basilar Artery ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion ◽  
Minor Head Trauma

scholarly journals Predictors of Good Outcome After Stent-Retriever Thrombectomy in Acute Basilar Artery Occlusion

Stroke ◽  
2015 ◽  
Vol 46 (10) ◽  
pp. 2972-2975 ◽  
Author(s):  
Woong Yoon ◽  
Seul Kee Kim ◽  
Tae Wook Heo ◽  
Byung Hyun Baek ◽  
Yun Young Lee ◽  
...  
Keyword(s):  
Basilar Artery ◽  
Artery Occlusion ◽  
Stent Retriever ◽  
Basilar Artery Occlusion ◽  
Good Outcome

Bridging versus direct endovascular therapy in basilar artery occlusion

2021 ◽  
pp. jnnp-2020-325328
Author(s):  
Sergio Nappini ◽  
Francesco Arba ◽  
Giovanni Pracucci ◽  
Valentina Saia ◽  
Danilo Caimano ◽  
...  
Keyword(s):  
Ischaemic Stroke ◽  
Functional Outcome ◽  
Basilar Artery ◽  
Endovascular Therapy ◽  
Recombinant Tissue Plasminogen Activator ◽  
Artery Occlusion ◽  
Lower Mortality ◽  
Basilar Artery Occlusion ◽  
Bridging Therapy ◽  
Procedural Complications

BackgroundWe evaluated safety and efficacy of intravenous recombinant tissue Plasminogen Activator plus endovascular (bridging) therapy compared with direct endovascular therapy in patients with ischaemic stroke due to basilar artery occlusion (BAO).MethodsFrom a national prospective registry of endovascular therapy in acute ischaemic stroke, we selected patients with BAO. We compared bridging and direct endovascular therapy evaluating vessel recanalisation, haemorrhagic transformation at 24–36 hours; procedural complications; and functional outcome at 3 months according to the modified Rankin Scale. We ran logistic and ordinal regression models adjusting for age, sex, National Institutes of Health Stroke Scale (NIHSS), onset-to-groin-puncture time.ResultsWe included 464 patients, mean(±SD) age 67.7 (±13.3) years, 279 (63%) males, median (IQR) NIHSS=18 (10–30); 166 (35%) received bridging and 298 (65%) direct endovascular therapy. Recanalisation rates and symptomatic intracerebral haemorrhage were similar in both groups (83% and 3%, respectively), whereas distal embolisation was more frequent in patients treated with direct endovascular therapy (9% vs 3%; p=0.009). In the whole population, there was no difference between bridging and direct endovascular therapy regarding functional outcome at 3 months (OR=0.79; 95% CI=0.55 to 1.13). However, in patients with onset-to-groin-puncture time ≤6 hours, bridging therapy was associated with lower mortality (OR=0.53; 95% CI=0.30 to 0.97) and a shift towards better functional outcome in ordinal analysis (OR=0.65; 95% CI=0.42 to 0.98).ConclusionsIn ischaemic stroke due to BAO, when endovascular therapy is initiated within 6 hours from symptoms onset, bridging therapy resulted in lower mortality and better functional outcome compared with direct endovascular therapy.

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