Mechanical thrombectomy treatment of basilar artery occlusion within 24 hours of symptom onset: A Single-Center Experience
V. 173 N. 5 (2022), Observational Study
V. 173 N. 5 (2022)

Mechanical thrombectomy treatment of basilar artery occlusion within 24 hours of symptom onset: A Single-Center Experience: doi: 10.7417/CT.2022.2454

Observational Study
Pubblicato 2022-09-28
N.V. Phuong
Department of Emergency, 108 Military Central Hospital, Hanoi, Vietnam
N. Cong Thanh
Department of Emergency, 108 Military Central Hospital, Hanoi, Vietnam
B. Keserci
Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
N.V. Sang
Department of Radiology, Medlatec Hospital, Hanoi, Vietnam - Department of Radiology, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam - Department of Radiology, E Hospital, Hanoi, Vietnam
N. Minh Duc
Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
https://orcid.org/0000-0001-5411-1492
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Parole chiave

basilar artery occlusion
recanalization
symptomatic intracerebral hemorrhage
futile recanalization

Abstract

Background: To evaluate the efficacy, safety, and predictive factors for clinical outcomes of mechanical thrombectomy (MT) performed within 24 hours of stroke onset in patients with basilar artery occlusion (BAO).

Methods: A prospective, single-center study collected clinical and imaging data from 49 patients with BAO treated with MT within 24 hours of stroke symptom onset. Direct suction using the Penumbra system and thrombus retrieval by Solitaire stent were the primary endovascular techniques used to restore basilar artery flow. Outcomes included angiographic recanalization success, improvement National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS) at discharge and after 3 months, and occurrence of symptomatic intracerebral hemorrhage (sICH) complications.

Results: The mean age was 67.6 ± 10.4 years (range, 47–88 years). The mean NIHSS and Glasgow Coma Scale (GCS) on admission were 22.9 ± 11.2 (range, 6–40) and 10.4 ± 3.1 (range, 5–15), respectively. The major etiologic risk factors were large artery atherosclerosis (83.7%), followed by cardioembolism (16.3%). Successful recanalization (thrombolysis in cerebral infarction [TICI] ≥ 2b) was achieved in all patients (100%), and TICI 3 was achieved in 93.9% of patients. Of the total sample, 6.1% (3/49) of patients showed NIHSS improvements of 0 points at discharge, and 24.9% (12/49) of patients showed NIHSS improvements of 10 points at discharge. After 3 months, 22 patients (44.9%) had favorable clinical outcomes (mRS 0–2), whereas 7 (14.3%) had poor outcomes (mRS 3–5); overall mortality was 40.8% (20/49). Complications of sICH were documented in 15.6% of patients. Univariate analysis identified atrial fibrillation (P = 0.016), NIHSS on admission < 15 (P = 0.032), and GCS on admission > 8 (P = 0.010) as predictive factors for favorable outcomes.

Conclusions: The current study suggests that MT treatment of BAO has high recanalization rates and good outcomes.

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