Article Text

PDF
Original research
Mechanical thrombectomy with the Solitaire device in acute basilar artery occlusion
  1. Isabelle Mourand1,
  2. Paolo Machi2,
  3. Didier Milhaud1,
  4. Marie-Christine Picot3,
  5. Kyriakos Lobotesis2,
  6. Caroline Arquizan1,
  7. Vincent Costalat2,
  8. Chérif Héroum1,
  9. Denis Sablot4,
  10. Stéphane Bouly5,
  11. Thibault Lalu6,
  12. Alain Bonafé2
  1. 1Neurology Department, University Hospital Center of Montpellier, Gui de Chauliac Hospital, Montpellier, France
  2. 2Neuroradiology Department, University Hospital Center of Montpellier, Gui de Chauliac Hospital, Montpellier, France
  3. 3Department of Medical Information, University Hospital Center of Montpellier, Gui de Chauliac Hospital, Montpellier, France
  4. 4Department of Neurology, CH, Perpignan, France
  5. 5Department of Neurology, CHU, Nîmes, France
  6. 6Department of Neurology, CH, Béziers, France
  1. Correspondance to Dr I Mourand, Neurology Department, CHRU, Gui de Chauliac Hospital, 80 avenue Augustin Fliche, Montpellier 34295, Cedex 5, France; i-mourand{at}chu-montpellier.fr

Abstract

Aims To evaluate the efficacy and safety of mechanical thrombectomy with the Solitaire FR device in revascularization of patients with acute basilar artery occlusion (ABAO) and to identify the predictive factors for clinical outcome.

Methods This prospective single-center study included 31 patients with acute ischemic stroke attributable to ABAO treated within the first 24 h after onset of symptoms with the Solitaire device. Nineteen patients simultaneously received intravenous thrombolysis. Recanalization rates after stent retrieval were determined and the clinical outcome and mortality rate were assessed 180 days after treatment.

Results The mean ±SD age of the patients was 61±17 years, the median prethrombectomy NIH Stroke Scale score was 38 (IQR 9–38) and the median Glasgow Coma Scale (GCS) score was 7 (IQR 4–14). Successful recanalization (TICI 3 or 2b) was achieved in 23 patients (74%). Five symptomatic intracranial hemorrhages were related to the procedure. Ten symptomatic distal migrations of thrombotic material occurred. A favorable outcome, defined as a modified Rankin Score (mRS) of 0–2, was observed in 35% of patients (11/31). Overall mortality rate was 32% (10/31). In the univariate analysis, elevated baseline glucose (p=0.008) was significantly associated with a poor outcome (mRS >2), whereas a tendency towards significance was observed with age (p=0.06), GCS on admission (p=0.07) and symptom-related lesions on T2 sequences (p=0.10). Patients with successful recanalization tended to have a better outcome (p=0.20).

Conclusion Mechanical thrombectomy with the Solitaire FR device can rapidly and effectively contribute to a high rate of recanalization and improve functional outcome in patients with ABAO and has an acceptable complication rate.

  • Stroke
  • Thrombectomy

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.