title: Endovascular treatment of basilar artery occlusion by manual aspiration thrombectomy.
abstract: OBJECTIVE
  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.
authors: Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors: Brian T
authors: BT
authors: Jankowitz
authors: Aitziber
authors: A
authors: Aleu
authors: Ridwan
authors: R
authors: Lin
authors: Mouhammad
authors: M
authors: Jumaa
authors: Hilal
authors: H
authors: Kanaan
authors: Dean
authors: D
authors: Kostov
authors: Maxim
authors: M
authors: Hammer
authors: Ken
authors: K
authors: Uchino
authors: Larry R
authors: LR
authors: Wechsler
authors: Michael
authors: M
authors: Horowitz
authors: Tudor G
authors: TG
authors: Jovin
mesh_terms: D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D001488:Basilar Artery / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000601:surgery; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D013396:Suction / Q000379:methods; D017131:Thrombectomy / Q000379:methods*; D015912:Thrombolytic Therapy / Q000379:methods; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D010959:Tissue Plasminogen Activator