title: Mechanical thrombectomy with stent retrievers in acute basilar artery occlusion.
abstract: OBJECTIVE
  Basilar artery occlusion remains one of the most devastating subtypes of ischemic stroke. The prognosis is poor if early recanalization is not achieved. The purpose of this study was to evaluate the safety and technical feasibility of self-expanding retrievable stents in the endovascular treatment of acute basilar artery occlusion.
  
  
  METHODS
  Twenty-four patients with acute basilar artery occlusion were treated with Solitaire FR or Revive SE devices between December 2009 and May 2012. Additional treatment included intravenous and/or intra-arterial thrombolysis (21/24) and percutaneous transluminal angioplasty/permanent stent placement (7/24). Recanalization was assessed by means of the TICI score. Clinical outcome was determined at discharge (NIHSS), and at 3 months (mRS).
  
  
  RESULTS
  Median NIHSS score on admission was 24; median duration of symptoms was 254 minutes. Successful recanalization (TICI 2b +3) by thrombectomy only was achieved in 18 patients (75%). Intracranial stent deployment after thrombectomy caused by underlying atherosclerotic stenosis was performed in 7 patients. If these patients with intracranial stent placement are included, successful recanalization was achieved in 21 of 24 patients (87.5%). NIHSS improvement ≥10 points was reached in 54% of patients (n = 13/24). Mortality during the first 3 months was 29% (7/24). After 3 months, 8 patients (33%) had a favorable clinical outcome (mRS 0-2).
  
  
  CONCLUSIONS
  In our series, application of self-expanding retrievable stents in acute basilar artery occlusion resulted in a high recanalization rate without procedural complications and good clinical outcome in one-third of patients.
authors.affiliation: From the Departments of Neuroradiology (M.M., S.S., L.B., C.H., S.R., M.B., M.P.) markus.moehlenbruch@med.uni-heidelberg.de.
authors.forename: M
authors.initials: M
authors.lastname: Möhlenbruch
authors.affiliation: From the Departments of Neuroradiology (M.M., S.S., L.B., C.H., S.R., M.B., M.P.).
authors.forename: S
authors.initials: S
authors.lastname: Stampfl
authors.affiliation: From the Departments of Neuroradiology (M.M., S.S., L.B., C.H., S.R., M.B., M.P.).
authors.forename: L
authors.initials: L
authors.lastname: Behrens
authors.affiliation: From the Departments of Neuroradiology (M.M., S.S., L.B., C.H., S.R., M.B., M.P.).
authors.forename: C
authors.initials: C
authors.lastname: Herweh
authors.affiliation: From the Departments of Neuroradiology (M.M., S.S., L.B., C.H., S.R., M.B., M.P.).
authors.forename: S
authors.initials: S
authors.lastname: Rohde
authors.affiliation: From the Departments of Neuroradiology (M.M., S.S., L.B., C.H., S.R., M.B., M.P.).
authors.forename: M
authors.initials: M
authors.lastname: Bendszus
authors.affiliation: From the Departments of Neuroradiology (M.M., S.S., L.B., C.H., S.R., M.B., M.P.)Neurology (C.H., S.N., P.A.R.), University of Heidelberg Medical Center, Heidelberg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Hametner
authors.affiliation: Neurology (C.H., S.N., P.A.R.), University of Heidelberg Medical Center, Heidelberg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Nagel
authors.affiliation: Neurology (C.H., S.N., P.A.R.), University of Heidelberg Medical Center, Heidelberg, Germany.
authors.forename: P A
authors.initials: PA
authors.lastname: Ringleb
authors.affiliation: From the Departments of Neuroradiology (M.M., S.S., L.B., C.H., S.R., M.B., M.P.).
authors.forename: M
authors.initials: M
authors.lastname: Pham
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002548:Cerebral Revascularization / Q000295:instrumentation*; D020878:Device Removal / Q000295:instrumentation*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008297:Male; D061185:Mechanical Thrombolysis / Q000295:instrumentation*; D008875:Middle Aged; D011859:Radiography; D015607:Stents; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging* / Q000601:surgery*