A leap forward in the endovascular management of acute basilar artery occlusion since the appearance of stent retrievers: a single-center comparative study

被引：29

作者：

Fahed, Robert ^{[1
]}

Di Maria, Federico ^{[1
]}

Rosso, Charlotte ^{[2
,4
,5
]}

Sourour, Nader ^{[1
]}

Degos, Vincent ^{[3
,4
]}

Deltour, Sandrine ^{[2
]}

Baronnet-Chauvet, Flore ^{[2
,4
]}

Leger, Anne ^{[2
]}

Crozier, Sophie ^{[2
]}

Gabrieli, Joseph ^{[1
,4
]}

Samson, Yves ^{[2
,4
,5
]}

Chiras, Jacques ^{[1
,4
]}

Clarencon, Frederic ^{[1
,4
]}

机构：

[1] Hop La Pitie Salpetriere, Dept Intervent Neuroradiol, 47-83 Blvd Hop, F-75013 Paris, France

[2] Hop La Pitie Salpetriere, Dept Vasc Neurol, Paris, France

[3] Hop La Pitie Salpetriere, Dept Anesthesiol, Paris, France

[4] Paris VI Univ Pierre & Marie Curie, Paris, France

[5] INSERM, Ctr Rech, Inst Cerveau & Moelle Epiniere, Paris, France

来源：

JOURNAL OF NEUROSURGERY | 2017年 / 126卷 / 05期

关键词：

basilar artery occlusion; thrombectomy; endovascular; stent retriever; vascular disorders; ACUTE ISCHEMIC-STROKE; INTRAVENOUS T-PA; THERAPY; TRIAL; THROMBECTOMY;

D O I：

10.3171/2016.2.JNS151983

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

OBJECTIVE Contrary to acute ischemic stroke involving the anterior circulation, no randomized trial has yet demonstrated the safety and effectiveness of endovascular management in acute basilar artery occlusion (BAO). Recently developed thrombectomy devices, such as stentrievers and aspiration systems, have helped in improving the endovascular management of acute ischemic stroke. The authors sought to assess the impact of these devices in the endovascular treatment of acute BAO. METHODS A retrospective analysis of 34 consecutive patients treated in Pitie-Salpetriere Hospital for acute BAO was carried out. All patients had undergone an endovascular procedure. In addition to the global results in terms of safety and effectiveness (recanalization rate and 3-month clinical outcome based on the modified Rankin Scale [mRS]), the authors aimed to determine if the patients treated with the most recently developed devices (i.e., the Solitaire stentriever or the ADAPT catheter) had better angiographic and clinical outcomes than those treated with older endovascular strategies. RESULTS The overall successful recanalization rate (thrombolysis in cerebral infarction score 2b-3) was 50% (17 of 34 patients). A good clinical outcome (mRS score 0-2 at 3-month follow-up) was achieved in 11 (32.3%) of 34 patients. The mortality rate at 3-month follow-up was 29.4% (10 of 34 patients). Patients treated with the Solitaire stentriever and the ADAPT catheter had a higher recanalization rate (12 [92.3%] of 13 patients vs 5 [23.8%] of 21 patients, p = 0.0002) and a shorter mean (+/- SD) procedure duration (88 +/- 31 minutes vs 126 +/- 58 minutes, p = 0.04) than patients treated with older devices. CONCLUSIONS The latest devices have improved the effectiveness of mechanical thrombectomy in acute BAO. Their use in further studies may help demonstrate a benefit in the endovascular management of acute BAO.

引用

页码：1578 / 1584

页数：7

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