Article Figures & Data
Figures
- Fig 1.
Patient 7, a 43-year-old male, with hemiplegia right, anarthria, and dysphagia for 7.5 hours. Occlusion of the extra- and intracranial left VA and the entire BA is shown.
- Fig 2.
Collateralization of the tip of the BA.
- Fig 3.
The Choice-PT microwire (black) with its tip in the posterior cerebral artery (white vessels) straightened the atlas loop (white line in the roadmap) and the Angiojet reached the basilar tip.
- Fig 4.
Complete thrombus extraction was achieved, but a high-grade stenosis of the VA remained.
- Fig 5.
The stenosis worsened due to rethrombosis despite heparinization (ACT >250).
- Fig 6.
Therefore, tirofiban was infused, and a 4-mm Medtronic stent was implanted. Complete recanalization was achieved. Shortly after the procedure, the patient improved significantly and returned to work.
Tables
Patient (no.) Sex Age (y) BA, Top BA, Mid BA, Caudal V4 Vc Catheter Access PreTIMI jet PostTIMI jet TIMI end Embolism % Stenosis Site Angioplasty 1 M 49 x x x x 5F Yes 0 2 3 — 95, V4 Stent 2 M 47 x 5F Yes 1 3 3 P2 50, V1 — 3 M 56 x x x x x 5F Yes 0 3 3 — 70, V1 — 4 F 61 x x 5F No 0 n.a.* 3 — 95, V4 Balloon 5 M 62 x x x 5F Yes 0 3 3 — 70, BA Balloon 6 M 55 x x x x 5F No 0 n.a.* 2 — 80, BA — 7 M 43 x x x x x 5F Yes 0 3 3 — 80, V4 Stent 8 M 62 x x x x 4F Yes 0 3 3 — 95, BA Stent 9 F 40 x 4F Yes 1 3 3 — — — 10 M 73 x x x 4F Yes 0 3 3 — 90, BA Stent 11 M 64 x x x 4F Yes 0 2 2 — 80, V4 — 12 F 54 x x 4F Yes 0 1 3 — — — * Note.—: no access-no angiojet treatment possible; BA: basilar artery; n.a.: not applicable; V1: orgin of the vertebral artery; V4: intracranial segment of the vertebral artery; Vc: cervical segments of the vertebral artery; x: occluded segments.
Patient (no.) mg rt-PA Order Antiplatelet Hematoma Sites of Infarction Time (h) Window of Stroke Time (h) Window of Coma NIHSS, Prior GCS, Prior MRS, After 3 Months 1 80 after Tirofiban ICH, SAH c 7 5 21 6 6 2 — — — o 5 4.5 26 4 3 3 40 before — — c, o 18 3 25 5 6 4 * — ICH c 216 6 25 5 6 5 — — — — 8.5 8 23 5 1 6 *120 — ICH, SAH b, c 4 0 19 10 6 7 — Tirofiban — c 7.5 0 20 13 1 8 — Tirofiban — b 7 4 21 7 5 9 15 before — — — 0 0 n.a.** n.a.** 0 10 — Tirofiban SAH b 84 0 12 13 3 11 — Tirofiban — c 12 6 13 4 6 12 60 after — SAH c, o 15 0 14 13 1 * Note.—: no access-no angiojet treatment possible;
** Note.—: patient was under general anesthesia, when occlusion occurred; b = brainstem infarction; c = cerebellar infarction; GCS: Glasgow coma scale; ICH: intracerebral hemorrhage; MRS: Modified Rankin Scale (0 = normal, 6 = deceased); n.a.: not applicable; NIH: National Institutes of Health Stroke Scale; o = occipital and thalamic infarction; SAH: subarachnoid hemorrhage.
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