TY - JOUR T1 - Endovascular treatment of basilar artery occlusion by manual aspiration thrombectomy JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg SP - 110 LP - 114 DO - 10.1136/jnis.2009.001420 VL - 2 IS - 2 AU - Brian T Jankowitz AU - Aitziber Aleu AU - Ridwan Lin AU - Mouhammad Jumaa AU - Hilal Kanaan AU - Dean Kostov AU - Maxim Hammer AU - Ken Uchino AU - Larry R Wechsler AU - Michael Horowitz AU - Tudor G Jovin Y1 - 2010/06/01 UR - http://jnis.bmj.com/content/2/2/110.abstract N2 - 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. ER -