RT Journal Article
SR Electronic
T1 Frontline thrombectomy strategy and outcome in acute basilar artery occlusion
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 27
OP 33
DO 10.1136/neurintsurg-2021-018180
VO 15
IS 1
A1 Abdelrady, Mohamed
A1 Ognard, Julien
A1 Cagnazzo, Federico
A1 Derraz, Imad
A1 Lefevre, Pierre-Henri
A1 Riquelme, Carlos
A1 Gascou, Gregory
A1 Arquizan, Caroline
A1 Dargazanli, Cyril
A1 Cheddad El Aouni, Mourad
A1 Ben Salem, Douraied
A1 Mourand, Isabelle
A1 Costalat, Vincent
A1 Gentric, Jean Christophe
A1 
YR 2023
UL http://jnis.bmj.com/content/15/1/27.abstract
AB Background Novel thrombectomy strategies emanate expeditiously day-by-day counting on access system, clot retriever device, proximity to and integration with the thrombus, and microcatheter disengagement. Nonetheless, the relationship between native thrombectomy strategies and revascularization success remains to be evaluated in basilar artery occlusion (BAO).Purpose To compare the safety and efficacy profile of key frontline thrombectomy strategies in BAO.Methods Retrospective analyses of prospectively maintained stroke registries at two comprehensive stroke centers were performed between January 2015 and December 2019. Patients with BAO selected after MR imaging were categorized into three groups based on the frontline thrombectomy strategy (contact aspiration (CA), stent retriever (SR), or combined (SR+CA)). Patients who experienced failure of clot retrieval followed by an interchanging strategy were categorized as a fourth (switch) group. Clinicoradiological features and procedural variables were compared. The primary outcome measure was the rate of complete revascularization (modified Thrombolysis in Cerebral Infarction (mTICI) grade 2c–3). Favorable outcome was defined as a 90 day modified Rankin Scale score of 0–2.Results Of 1823 patients, we included 128 (33 underwent CA, 35 SR, 35 SR +CA, and 25 switch techniques). Complete revascularization was achieved in 83/140 (59%) primarily analyzed patients. SR +CA was associated with higher odds of complete revascularization (adjusted OR 3.04, 95% CI 1.077 to 8.593, p=0.04) which was an independent predictor of favorable outcome (adjusted OR 2.73. 95% CI 1.152 to 6.458, p=0.02). No significant differences were observed for symptomatic intracranial hemorrhage, functional outcome, or mortality rate.Conclusion Among BAO patients, the combined technique effectively contributed to complete revascularization that showed a 90 day favorable outcome with an equivalent complication rate after thrombectomy.Data are available upon reasonable request.