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Research ArticleNeurointervention

Mechanical Thrombectomy with Stent Retrievers in Acute Basilar Artery Occlusion

M. Möhlenbruch, S. Stampfl, L. Behrens, C. Herweh, S. Rohde, M. Bendszus, C. Hametner, S. Nagel, P.A. Ringleb and M. Pham
American Journal of Neuroradiology May 2014, 35 (5) 959-964; DOI: https://doi.org/10.3174/ajnr.A3796
M. Möhlenbruch
aFrom the Departments of Neuroradiology (M.M., S.S., L.B., C.H., S.R., M.B., M.P.)
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S. Stampfl
aFrom the Departments of Neuroradiology (M.M., S.S., L.B., C.H., S.R., M.B., M.P.)
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L. Behrens
aFrom the Departments of Neuroradiology (M.M., S.S., L.B., C.H., S.R., M.B., M.P.)
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C. Herweh
aFrom the Departments of Neuroradiology (M.M., S.S., L.B., C.H., S.R., M.B., M.P.)
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S. Rohde
aFrom the Departments of Neuroradiology (M.M., S.S., L.B., C.H., S.R., M.B., M.P.)
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M. Bendszus
aFrom the Departments of Neuroradiology (M.M., S.S., L.B., C.H., S.R., M.B., M.P.)
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C. Hametner
aFrom the Departments of Neuroradiology (M.M., S.S., L.B., C.H., S.R., M.B., M.P.)
bNeurology (C.H., S.N., P.A.R.), University of Heidelberg Medical Center, Heidelberg, Germany.
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S. Nagel
bNeurology (C.H., S.N., P.A.R.), University of Heidelberg Medical Center, Heidelberg, Germany.
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P.A. Ringleb
bNeurology (C.H., S.N., P.A.R.), University of Heidelberg Medical Center, Heidelberg, Germany.
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M. Pham
aFrom the Departments of Neuroradiology (M.M., S.S., L.B., C.H., S.R., M.B., M.P.)
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  • Article
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Article Figures & Data

Tables

    • View popup
    Table 1:

    Comparison of baseline stroke severity and outcome variables between this study and others with the use of a stent retriever in acute basilar artery occlusion

    N(BAO)/N (Total)NIHSS InitialSuccessful Recanalization (TICI 2b–3), %sICH, %mRS 0–2 After 90 Days, %90-Day Mortality, %
    Roth et al238/221987.512.537.550
    Miteff et al2410/2631100 (TIMI 3 in 33)a102033
    Costalat et al2516/50?81 (TICI 3)6.34425
    Dorn et al2624/1081677.9NANA47.8b
    Mordasini et al2714/142110002936
    Espinosa et al2818/18209405022
    Mourand et al2931/313874163532
    Study group24/242487.583329
    • Note:—N indicates number of patients; NA, not available; sICH, symptomatic intracerebral hemorrhage.

    • ↵a TIMI (Thrombolysis In Myocardial Infarction) grade 2 or 3;

    • ↵b at discharge.

    • View popup
    Table 2:

    Angiographic/treatment data

    Patient No.TICI at BaselineTICI at End PointNo. of PassesType of DeviceIntracranial Stent PlacementIV rtPAIA rtPAConcurrent Medication
    1031S054200
    2034S000A
    302b4S05520T
    402b2S13521T
    502b2S14113T
    602a1S14716T
    7032S1520T
    802b1R05016T
    9034R04500
    10000005000
    1102b7R100T
    1202b3R1670T
    1302b2R05000
    14031R09000
    1502b1R0430H
    16032R06900
    1702b2R09000
    18036R, S0000
    1912b2S05000
    2002b3R03800
    21031S1730T
    22032R06000
    230010R, S0680T
    2412b4R06000
    • Note:—“No. of Passes” refers to the number of passes needed for recanalization. A indicates aspirin; H, heparin; R, Revive SE; S, Solitaire FR; T, tirofiban; IA, intra-arterial.

    • View popup
    Table 3:

    Patient outcomes/complications

    Patient No.NHISS at BaselineNHISS at DischargemRS at DischargemRS at 90 DaysICHComplication
    11701000
    23875500
    335a66AS0
    4191250OUA
    526a660OUA
    638174400
    71622300
    839a66S0
    942225600
    1040a6600
    112128550VAS
    127a660OUA
    13222320D V2
    143053300
    15271120D V1
    162243200
    17106420OUA
    18378430D V1
    19123320D V2
    2021155400
    213043200
    22240000VAS
    23–a6600
    2417104300
    • Note:—AS indicates asymptomatic; D, dissection; OUA, thromboembolic occlusion of a previously unaffected artery; S, symptomatic; V1, V2, segment of the vertebral artery; VAS, vasospasm; –, absent.

    • ↵a Deceased.

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American Journal of Neuroradiology: 35 (5)
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M. Möhlenbruch, S. Stampfl, L. Behrens, C. Herweh, S. Rohde, M. Bendszus, C. Hametner, S. Nagel, P.A. Ringleb, M. Pham
Mechanical Thrombectomy with Stent Retrievers in Acute Basilar Artery Occlusion
American Journal of Neuroradiology May 2014, 35 (5) 959-964; DOI: 10.3174/ajnr.A3796

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Mechanical Thrombectomy with Stent Retrievers in Acute Basilar Artery Occlusion
M. Möhlenbruch, S. Stampfl, L. Behrens, C. Herweh, S. Rohde, M. Bendszus, C. Hametner, S. Nagel, P.A. Ringleb, M. Pham
American Journal of Neuroradiology May 2014, 35 (5) 959-964; DOI: 10.3174/ajnr.A3796
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Cited By...

  • Successful mechanical thrombectomy in acute ischemic stroke: revascularization grade and functional independence
  • Diagnosis and management of acute ischaemic stroke
  • Prediction of intracranial hemorrhages after mechanical thrombectomy of basilar artery occlusion
  • Redefining 'success: a systematic review and meta-analysis comparing outcomes between incomplete and complete revascularization
  • Equivalent favorable outcomes possible after thrombectomy for posterior circulation large vessel occlusion compared with the anterior circulation: the MUSC experience
  • Revolution in acute ischaemic stroke care: a practical guide to mechanical thrombectomy
  • Acute Basilar Artery Occlusion: Differences in Characteristics and Outcomes after Endovascular Therapy between Patients with and without Underlying Severe Atherosclerotic Stenosis
  • Outcomes of endovascular treatment of basilar artery occlusion in the stent retriever era: a systematic review and meta-analysis
  • Initial factors affecting the clinical outcome after successful recanalization via MR-based mechanical thrombectomy in patients with acute ischemic stroke due to basilar artery occlusion
  • Republished: A novel route of revascularization in basilar artery occlusion and review of the literature
  • Mechanical thrombectomy using a combined CT/C-arm X-ray system
  • Outcomes of stent retriever thrombectomy in basilar artery occlusion: an observational study and systematic review
  • Mechanical Thrombectomy of Distal Occlusions in the Anterior Cerebral Artery: Recanalization Rates, Periprocedural Complications, and Clinical Outcome
  • The Revascularization Scales Dilemma: Is It Right to Apply the Treatment in Cerebral Ischemia Scale in Posterior Circulation Stroke?
  • Comparison of Solitaire thrombectomy and Penumbra suction thrombectomy in patients with acute ischemic stroke caused by basilar artery occlusion
  • Combined Use of Mechanical Thrombectomy with Angioplasty and Stenting for Acute Basilar Occlusions with Underlying Severe Intracranial Vertebrobasilar Stenosis: Preliminary Experience from a Single Chinese Center
  • Predictors of Good Outcome After Stent-Retriever Thrombectomy in Acute Basilar Artery Occlusion
  • A novel route of revascularization in basilar artery occlusion and review of the literature
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