Mechanical thrombectomy in patients with acute vertebrobasilar occlusion using the Trevo device: a single-centre experience

The purpose of this study is to investigate the efficacy and safety of mechanical thrombectomy in patients with acute vertebrobasilar artery occlusion (VBAO) using the Trevo Stentriever (TM) device. Twenty patients diagnosed with VBAO underwent digital subtraction angiography (DSA) with the intention to perform mechanical thrombectomy with stent-retrievers between August 2011 and October 2013. Two patients were excluded because another device was primarily used; in two other patients, thrombectomy was not possible. Thrombectomy with the Trevo device was performed in 16 patients. The Stentriever (TM) was used either as the sole device (56.3 %) or in conjunction with up to four additional devices or techniques. Thirty-three clot retrieval manoeuvres were performed (mean 2.1 +/- 1.3, range 1-5); the device could be deployed and retrieved in all manoeuvres (100 %). No device-related complications occurred. Mean duration of the endovascular intervention was 71.8 min (+/- 39.9; range 22-144). Complete or near complete recanalization (thrombolysis in cerebral infarction (TICI) a parts per thousand yen2b) was achieved in 13 patients (81.3 %). Eleven patients (68.8 %) survived and seven patients (43.8 %) showed a good clinical outcome at discharge, defined as modified Rankin Scale (mRS) 0-2 or National Institute of Health Stroke Scale (NIHSS) improvement a parts per thousand yen10 points. Including the two patients in whom thrombectomy was not possible, successful recanalization, good clinical outcome and survival were achieved in 72.2, 38.9 and 61.1 %, respectively. Thrombectomy in patients with acute VBAO using the Trevo Stentriever (TM) aEuro"either as the sole device or in conjunction with other devices-is feasible and seems to be similarly effective and safe as in the anterior circulation compared to reported data in the literature.