title: Preliminary findings of recanalization and stenting for symptomatic vertebrobasilar artery occlusion lasting more than 24h: a retrospective analysis of 21 cases.
abstract: OBJECTIVE
  To evaluate the technical feasibility, safety and short-term treatment effects of recanalization and stenting for intracranial symptomatic vertebrobasilar artery occlusion (VBAO) lasting more than 24h.
  
  
  METHODS
  Twenty-one consecutive patients with VBAO refractory to aggressive medical treatment were enrolled into this study and underwent recanalization and stenting. The rate of recanalization was evaluated radiographically and the functional outcome was examined using modified Rankin Scale (mRS) scores.
  
  
  RESULTS
  Median time between imaging-documented occlusion and endovascular recanalization was 10.5 days (IR, Interquartile Range: 6.5-18); technique success ratio of recanalization was 95.2%. There were 3 periprocedural complications. Median mRS score was 4 (IR, 2.5-5) prior to procedure and 4 (IR, 1-5) at discharge (P<0.05). One stroke and one death occurred within 30 days after recanalization. Mean duration of clinical follow-up was 15.5 months. One transient ischemic attack, one stroke and one death occurred beyond 30-day window. Mean angiographic follow-up was 10.6 months in 10 patients. Four patients developed in-stent restenosis or occlusion, and two of them were symptomatic. Subgroup analyses revealed better functional recovery (lower mRS) in patients with vertebral artery occlusion (VAO) (P<0.05).
  
  
  CONCLUSIONS
  Endovascular recanalization and stenting for symptomatic VBAO lasting more than 24h were technically feasible and patients with VAO benefited from the treatment with significant functional recovery. However, the complexity of the procedure and high risk of complication should prompt extreme caution.
authors.affiliation: Cerebrovascular Center, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China. heyingkun@126.com
authors.forename: Yingkun
authors.initials: Y
authors.lastname: He
authors.forename: Ziliang
authors.initials: Z
authors.lastname: Wang
authors.forename: Tianxiao
authors.initials: T
authors.lastname: Li
authors.forename: Wei-Jian
authors.initials: WJ
authors.lastname: Jiang
authors.forename: Liangfu
authors.initials: L
authors.lastname: Zhu
authors.forename: Jiangyu
authors.initials: J
authors.lastname: Xue
authors.forename: Weixing
authors.initials: W
authors.lastname: Bai
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Hui
mesh_terms: D001807:Blood Vessel Prosthesis; D002548:Cerebral Revascularization / Q000009:adverse effects / Q000379:methods*; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000175:diagnosis* / Q000601:surgery*
keywords: Occlusion; Recanalization; Stenting; Vertebrobasilar