title: Mechanical thrombectomy with the Solitaire device in acute basilar artery occlusion.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of mechanical thrombectomy with the Solitaire FR device in revascularization of patients with acute basilar artery occlusion (ABAO) and to identify the predictive factors for clinical outcome.
  
  
  METHODS
  This prospective single-center study included 31 patients with acute ischemic stroke attributable to ABAO treated within the first 24 h after onset of symptoms with the Solitaire device. Nineteen patients simultaneously received intravenous thrombolysis. Recanalization rates after stent retrieval were determined and the clinical outcome and mortality rate were assessed 180 days after treatment.
  
  
  RESULTS
  The mean ±SD age of the patients was 61±17 years, the median prethrombectomy NIH Stroke Scale score was 38 (IQR 9-38) and the median Glasgow Coma Scale (GCS) score was 7 (IQR 4-14). Successful recanalization (TICI 3 or 2b) was achieved in 23 patients (74%). Five symptomatic intracranial hemorrhages were related to the procedure. Ten symptomatic distal migrations of thrombotic material occurred. A favorable outcome, defined as a modified Rankin Score (mRS) of 0-2, was observed in 35% of patients (11/31). Overall mortality rate was 32% (10/31). In the univariate analysis, elevated baseline glucose (p=0.008) was significantly associated with a poor outcome (mRS >2), whereas a tendency towards significance was observed with age (p=0.06), GCS on admission (p=0.07) and symptom-related lesions on T2 sequences (p=0.10). Patients with successful recanalization tended to have a better outcome (p=0.20).
  
  
  CONCLUSIONS
  Mechanical thrombectomy with the Solitaire FR device can rapidly and effectively contribute to a high rate of recanalization and improve functional outcome in patients with ABAO and has an acceptable complication rate.
authors: Neurology Department, University Hospital Center of Montpellier, Gui de Chauliac Hospital, Montpellier, France.
authors: Isabelle
authors: I
authors: Mourand
authors: Paolo
authors: P
authors: Machi
authors: Didier
authors: D
authors: Milhaud
authors: Marie-Christine
authors: MC
authors: Picot
authors: Kyriakos
authors: K
authors: Lobotesis
authors: Caroline
authors: C
authors: Arquizan
authors: Vincent
authors: V
authors: Costalat
authors: Chérif
authors: C
authors: Héroum
authors: Denis
authors: D
authors: Sablot
authors: Stéphane
authors: S
authors: Bouly
authors: Thibault
authors: T
authors: Lalu
authors: Alain
authors: A
authors: Bonafé
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001488:Basilar Artery / Q000473:pathology / Q000601:surgery*; D002545:Brain Ischemia / Q000209:etiology; D002533:Cerebral Angiography; D003131:Combined Modality Therapy; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000209:etiology; D017131:Thrombectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Stroke; Thrombectomy