Purpose The present our experience in mechanical thrombectomy for acute basilar artery occlusion.
Method and material By reviewing our databank, in the last 300 patients of acute cerebral ischemic stroke of large vessel occlusion, we found 29 patients were due to basilar artery occlusion (BAO). The inclusion criteria were; >18 years old, no evidence of hemorrhage on CT, BAO found on CTA, bridging therapy after IV-tPA in eligible patients, posterior circulation ASPECTS >6. We recorded the initial NIHSS, time from onset to needle, method of recanalization, TICI, time of recanalization, 24- hour follow up imaging, and mRS at 90 days.
Result In these 29 patients, they were 14 were males, 68 years old (42–81 years old). The initial NIHSS at emergency department was 27 (standard deviation (SD)= 7.3); 8 of them received IV-tPA, the average time from onset to needle was 417 minutes (SD = 38.9); 93.1% (27/29) using aspiration as first method of recanalization; TICI =3 or 2b in 86.2% (25/29); 41.4% (12/29) associated with basilar artery stenosis; on the 24-hour follow up imaging, parenchymal hemorrhage was found in 3 and hemorrhagic transformation in 3; the mRS (0–2) at 90 days was 55.1%(16/29), and the mortality rate was 10.3% (3/29).
Conclusion Acute basilar artery occlusion is a complex and severe disease, endovascular thrombectomy can have a high rate of recanalization but the clinical outcome on 90 days still worse than the one in anterior circulation. The treatment will become more challenge in patient associated with underlying intracranial atherosclerotic stenosis.
Disclosures H. Liu: 3; C; Stryker, GE. C. Lee: None. Y. Lin: None. C. Wan: None.
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