title: Forced arterial suction thrombectomy with the penumbra reperfusion catheter in acute basilar artery occlusion: a retrospective comparison study in 2 Korean university hospitals.
abstract: OBJECTIVE
  A performance of forced arterial suction thrombectomy was not reported for the treatment of acute basilar artery occlusion. This study compared revascularization performance between intra-arterial fibrinolytic treatment and forced arterial suction thrombectomy with a Penumbra reperfusion catheter in patients with acute basilar artery occlusion.
  
  
  METHODS
  Fifty-seven patients with acute basilar artery occlusion were treated with intra-arterial fibrinolysis (n = 25) or forced arterial suction thrombectomy (n = 32). Baseline characteristics, successful revascularization rate, and clinical outcomes were compared between the groups.
  
  
  RESULTS
  Baseline characteristics, the frequency of patients receiving intravenous recombinant tissue plasminogen activator, and mean time interval between symptom onset and femoral puncture did not differ between groups. The forced arterial suction thrombectomy group had a shorter procedure duration (75.5 minutes versus 113.3 minutes, P = .016) and higher successful revascularization rate (88% versus 60%, P = .017) than the fibrinolysis group. Fair outcome, indicated by a modified Rankin Scale 0-3, at 3 months was achieved in 34% of patients undergoing forced arterial suction thrombectomy and 8% of patients undergoing fibrinolysis (P = .019), and the mortality rate was significantly higher in the fibrinolysis group (25% versus 68%, P = .001). Multiple logistic regression analysis identified the forced arterial suction thrombectomy method as an independent predictor of fair outcome with adjustment for age, sex, initial NIHSS score, and the use of intravenous recombinant tissue plasminogen activator (odds ratio, 7.768; 95% CI, 1.246-48.416; P = .028).
  
  
  CONCLUSIONS
  In acute basilar artery occlusion, forced arterial suction thrombectomy demonstrated a higher revascularization rate and improved clinical outcome compared with traditional intra-arterial fibrinolysis. Further clinical trials with the newer Penumbra catheter are warranted.
authors.affiliation: From the Departments of Neurology (Y.-I.E., J.M.H., J.S.L.).
authors.forename: Y-I
authors.initials: YI
authors.lastname: Eom
authors.affiliation: Departments of Neurology (Y.-H.H., Y.-W.K.).
authors.forename: Y-H
authors.identifier: http://orcid.org/0000-0002-6665-7481
authors.initials: YH
authors.lastname: Hwang
authors.affiliation: From the Departments of Neurology (Y.-I.E., J.M.H., J.S.L.).
authors.forename: J M
authors.initials: JM
authors.lastname: Hong
authors.affiliation: Radiology (J.W.C., S.Y.K.), Ajou University Medical Center, Suwon, South Korea.
authors.forename: J W
authors.initials: JW
authors.lastname: Choi
authors.affiliation: Department of Neurosurgery (Y.C.L.), Ajou University Hospital, Daegu, South Korea.
authors.forename: Y C
authors.initials: YC
authors.lastname: Lim
authors.affiliation: Neurosurgery (D.-H.K.) Radiology (D.-H.K., Y.-W.K., Y.-S.K.), Kyungpook National University Hospital, Daegu, South Korea.
authors.forename: D-H
authors.initials: DH
authors.lastname: Kang
authors.affiliation: Departments of Neurology (Y.-H.H., Y.-W.K.) Radiology (D.-H.K., Y.-W.K., Y.-S.K.), Kyungpook National University Hospital, Daegu, South Korea.
authors.forename: Y-W
authors.initials: YW
authors.lastname: Kim
authors.affiliation: Radiology (D.-H.K., Y.-W.K., Y.-S.K.), Kyungpook National University Hospital, Daegu, South Korea.
authors.forename: Y-S
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Radiology (J.W.C., S.Y.K.), Ajou University Medical Center, Suwon, South Korea.
authors.forename: S Y
authors.initials: SY
authors.lastname: Kim
authors.affiliation: From the Departments of Neurology (Y.-I.E., J.M.H., J.S.L.) jinsoo22@gmail.com.
authors.forename: J S
authors.initials: JS
authors.lastname: Lee
mesh_terms: D000368:Aged; D001488:Basilar Artery; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013396:Suction / Q000295:instrumentation*; D017131:Thrombectomy / Q000295:instrumentation*; D014715:Vertebrobasilar Insufficiency / Q000628:therapy*