title: First experiences with a new device for mechanical thrombectomy in acute basilar artery occlusion.
abstract: OBJECTIVE
  The aim of this study was to evaluate our first results using a new device for mechanical thrombectomy in patients with acute basilar artery occlusion.
  
  
  METHODS
  Between May 2009 and September 2010 a new device for aspiration thrombectomy (The Penumbra System™; Penumbra Inc., Alameda, Calif., USA) was used in 12 patients with acute basilar artery occlusion. We performed a retrospective review of these patients' medical records.
  
  
  RESULTS
  One patient received endovascular treatment without intravenous (IV) thrombolysis because of infarction on the initial CT scan. Eleven of 12 patients received IV thrombolysis with rtPA followed by endovascular thrombectomy according to a bridging concept. After thrombolysis, the basilar artery was patent in 1 patient (9%), partially recanalized in 3 (27%) and still occluded in 7 (64%). The endovascular device could not access in 2 patients (17%). Among the remaining 10 patients, the patency rate after thrombectomy was 100%. The overall patency rate after treatment was 9 of 12 (75%) at the time of discharge. National Institute of Health Stroke Scale improved from a median of 27 to a median of 18 after treatment. Four patients died (33%). The survivors had a mean modified Rankin Scale before discharge of 2.3 (range 0-4).
  
  
  CONCLUSIONS
  A bridging therapy with the combination of IV thrombolysis with recombinant tissue plasminogen activator and continuous aspiration thrombectomy seems to be a promising therapy strategy for acute basilar artery occlusion. Furthermore, our results confirm the advantage of the additional use of this new thrombectomy device, working with thrombus aspiration, with a satisfactory patency rate and a good clinical outcome.
authors.affiliation: Department of Neurology, Klinikum Kassel, Kassel, Germany. oth99@web.de
authors.forename: C
authors.initials: C
authors.lastname: Roth
authors.forename: A
authors.initials: A
authors.lastname: Mielke
authors.forename: R
authors.initials: R
authors.lastname: Siekmann
authors.forename: A
authors.initials: A
authors.lastname: Ferbert
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D004864:Equipment and Supplies / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017131:Thrombectomy / Q000295:instrumentation* / Q000379:methods*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000188:drug therapy / Q000601:surgery*
chemical_list: D010959:Tissue Plasminogen Activator