Mechanical thrombectomy as the primary treatment for acute basilar artery occlusion: experience from 5 years of practice
- Tommy Andersson1,2,
- Åsa Kuntze Söderqvist1,2,
- Michael Söderman1,2,
- Staffan Holmin1,2,
- Nils Wahlgren1,4,
- Magnus Kaijser1,2,3
- 1Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
- 2Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
- 3Clinical Epidemiology Unit, Department of Medicine at Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
- 4Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
- Correspondence to Dr M Kaijser, Department of Neuroradiology, Karolinska University Hospital, 17176, Stockholm 171 76, Sweden;
Contributors All authors contributed to the conception, design, analysis, interpretation of the data, drafting of the article and revising it critically for important intellectual content. All authors gave final approval of the version to be published.
- Received 17 June 2011
- Revised 29 January 2012
- Accepted 13 February 2012
- Published Online First 20 March 2012
Background Most studies of the treatment for acute basilar occlusion focus on intravenous or intra-arterial thrombolysis whereas data on mechanical thrombectomy as the preferred treatment for acute basilar occlusion are scarce. In this study, data are presented on 28 patients treated with mechanical thrombectomy as the preferred treatment for basilar artery occlusion.
Methods Retrospective study comprising all patients who were treated for acute basilar occlusion at the Karolinska University Hospital from September 2005 to November 2010. Favorable outcome was defined as a modified Rankin score of ≤2 at 3–8 months after thrombectomy.
Results Of 28 patients treated with mechanical thrombectomy, the proportion reaching a favorable outcome was 57% (95% CI 37% to 75%), and if there were no signs of acute infarction prior to treatment the proportion was 73% (95% CI 50% to 89%). Only 21% died (95% CI 8% to 41%).
Conclusions The results for mechanical thrombectomy for basilar artery occlusion were superior to those presented previously for intravenous and intra-arterial thrombolysis. The study suggests that mechanical thrombectomy is a method distinct from therapies based on thrombolysis and that any randomized clinical trial on treatment for acute basilar occlusion must consider mechanical thrombectomy as a separate entity.
Competing interests None.
Ethics approval The study was approved by the research ethics committee of Karolinska Institute.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement A more thorough description of the data than is presented above is available on request.