Distal protection of endovascular recanalization for symptomatic non-acute occlusion of vertebrobasilar artery

PurposeThe research aimed to investigate the safety and efficacy of distal protection of endovascular recanalization for symptomatic non-acute occlusion of the intracranial vertebrobasilar artery.Methods8 consecutive patients with symptomatic non-acute VBA from April 2023 to April 2024 who underwent endovascular recanalization were retrospectively analyzed.Results8 patients (median age 56 years; mean pretreatment National Institutes of Health Stroke Scale (NIHSS) score 6; 87.5% male) presenting with recurrent transient ischemic attacks(TIAs) (n = 1) or strokes (n = 23) were treated from April 2023 to April 2024. Median time from symptoms onset to treatment was 21 days(range: 10-43). Median time from occlusion confirmed to treatment was 13 days(range:8-26). Among the 8 patients, 8 (100%) achieved successful recanalization. The rate of periprocedural complications was 25%(2/8). Periprocedural complication included one asymptomatic intracranial hemorrhage(asICH) and thrombus translocation. The median follow-up time was 9 months (range: 6-12), with no stroke or TIA. At 90 days, there were one death (unrelated to the procedure) and 75% patients with an available modified Rankin Scale (mRS) score achieved a good outcome (mRS score of 0-2).ConclusionThe distal protection of stent retriever for endovascular recanalization for symptomatic non-acute occlusion of VBA is technically safe and may decrease procedure-related complications.