PT  - JOURNAL ARTICLE
AU  - Jankowitz, Brian T
AU  - Aleu, Aitziber
AU  - Lin, Ridwan
AU  - Jumaa, Mouhammad
AU  - Kanaan, Hilal
AU  - Kostov, Dean
AU  - Hammer, Maxim
AU  - Uchino, Ken
AU  - Wechsler, Larry R
AU  - Horowitz, Michael
AU  - Jovin, Tudor G
TI  - Endovascular treatment of basilar artery occlusion by manual aspiration thrombectomy
AID  - 10.1136/jnis.2009.001420
DP  - 2010 Jun 01
TA  - Journal of NeuroInterventional Surgery
PG  - 110--114
VI  - 2
IP  - 2
4099  - http://jnis.bmj.com/content/2/2/110.short
4100  - http://jnis.bmj.com/content/2/2/110.full
SO  - J NeuroIntervent Surg2010 Jun 01; 2
AB  - Background and purpose Basilar artery occlusion remains one of the most devastating subtypes of stroke. Intravenous and intra-arterial therapy have altered the natural history of this disease; however, clinical results remain poor. Therefore, exploring more aggressive and innovative management is warranted.Methods Six consecutive patients presenting with a basilar artery occlusion were treated with the same general algorithm of intra-arterial tissue plasminogen activator and mechanical thrombectomy with the Merci retrieval system. If complete recanalization was not achieved after two passes, manual syringe aspiration through a 4.3F catheter was employed.Results All interventions utilizing aspiration thrombectomy resulted in recanalization, with five out of six cases displaying TIMI3/TICI3 flow and one patient resulting in complete recanalization of the basilar artery with persistent thrombus in one P2 segment (TIMI2/TICI2B). All patients survived, with five out of six independent in activities of daily living at 3 months (mRS 0–2).Conclusions Our small case series indicates that aspiration thrombectomy performed manually through a 4.3F catheter can facilitate recanalization of basilar artery occlusion with acceptable clinical outcomes.