Effectiveness and Safety of Mechanical Thrombectomy with Stent Retrievers in Basilar Artery Occlusion : Comparison with Anterior Circulation Occlusions
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:60 |
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| Enthalten in: |
Journal of Korean Neurosurgical Society - 60(2017), 6 vom: 26. Nov., Seite 635-643 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hu, Soo Young [VerfasserIn] |
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| Anmerkungen: |
Date Revised 10.03.2022 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3340/jkns.2017.0404.008 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM27809063X |
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| 245 | 1 | 0 | |a Effectiveness and Safety of Mechanical Thrombectomy with Stent Retrievers in Basilar Artery Occlusion |b Comparison with Anterior Circulation Occlusions |
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| 500 | |a Date Revised 10.03.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a 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) | ||
| 520 | |a 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 | ||
| 520 | |a 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) | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Basilar artery | |
| 650 | 4 | |a Stents | |
| 650 | 4 | |a Stroke | |
| 650 | 4 | |a Thrombectomy | |
| 700 | 1 | |a Yi, Ho Jun |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Dong Hoon |e verfasserin |4 aut | |
| 700 | 1 | |a Hong, Jae Taek |e verfasserin |4 aut | |
| 700 | 1 | |a Sung, Jae Hoon |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Sang Won |e verfasserin |4 aut | |
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| 773 | 1 | 8 | |g volume:60 |g year:2017 |g number:6 |g day:26 |g month:11 |g pages:635-643 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.3340/jkns.2017.0404.008 |3 Volltext |
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