RT Journal Article
SR Electronic
T1 Endovascular treatment of basilar artery occlusion by manual aspiration thrombectomy
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 110
OP 114
DO 10.1136/jnis.2009.001420
VO 2
IS 2
A1 Brian T Jankowitz
A1 Aitziber Aleu
A1 Ridwan Lin
A1 Mouhammad Jumaa
A1 Hilal Kanaan
A1 Dean Kostov
A1 Maxim Hammer
A1 Ken Uchino
A1 Larry R Wechsler
A1 Michael Horowitz
A1 Tudor G Jovin
YR 2010
UL http://jnis.bmj.com/content/2/2/110.abstract
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.