Article Figures & Data
Figures
- Fig. 1.
Case of a 30-year-old woman comatous for 2 hours upon arrival at the hospital and during the angiography.
A, The anteroposterior view of the angiogram demonstrates the complete caudal occlusion of the BA. A microcatheter was placed in both VAS, and 140 mg of rtPA was administered.
B, An interim result showing partial recanalization.
C, The final result showing complete recanalization of the vertebrobasilar system. The patient was asymptomatic at first but developed a palsy of the right VI and VII cranial nerves 1 day later.
D, Follow-up MR imaging (T1-weighted, contrast-enhanced) confirms the subacute ischemic infarction in the right PICA territory and at the pontomedullary junction, where the nuclei of the VI and VII cranial nerves are located.
Tables
- Table 1:
Relationship between thrombus volume, etiology, site of occlusion, and recanialization
No Recanalization (%) Partial Recanalization (%) Complete Recanalization (%) n Thrombus volume (P < .001) <100 μl 10 9 81 57 100-300 μl 26 22 52 81 >300 μl 45 29 26 42 Etiology (not significant) Cardioembolism 27 20 52 99 Embolism from VA 21 5 74 19 Atherothrombotic 24 23 53 62 Site of occlusion (not significant) Midbasilar & rostral 22 17 61 93 Caudal 24 23 53 62 Cervical 40 20 40 25 Note:—VA indicates vertebral artery.
- Table 2:
Relationship between recanalization, etiology, VBO, site of occlusion, and posttreatment score
Posttreatment Scores n mRS 0-2 (%) mRS 3-4 (%) mRS 5-6 (%) Recanalization (P < .001) None 2 12 86 44 Partial 34 23 43 35 Complete 29 38 33 97 Etiology (not significant) Cardioembolism 22 30 48 98 Embolism from VA 22 39 39 18 Atherothrombotic 25 23 52 60 Pretreatment score (P < .001) mRS 3 71 29 0 14 mRS 4 28 30 42 60 mRS 5 14 27 59 102 Note:—VBO indicates vertebrobasilar occlusion; mRS, modified Rankin Scale; VA, vertebral artery.
- Table 3:
Relationship between duration of brain stem symptoms, coma duration, patient age, and posttreatment score
Posttreatment Scores n mRS 0–2 (%) mRS 3–4 (%) mRS 5–6 (%) Duration of brain stem symptoms (P < .020*) 0–4 hours 31 28 41 51 4.5–8 hours 22 29 49 63 8.5–12 hours 16 22 62 32 >12 hours 11 33 56 18 Coma duration (P < .001*) 0.5–4 hours 22 24 53 45 4.5–8 hours 10 26 65 31 8.5–12 hours 0 20 80 10 Patient’s age (P < .020) 22–39 years 42 25 33 24 40–69 years 22 31 47 118 >70 years 15 21 65 34 Note:—*indicates univariable testing; mRS, modified Rankin scale.
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