title: Mechanical thrombectomy in patients with acute vertebrobasilar occlusion using the Trevo device: a single-centre experience.
abstract: BACKGROUND
  The purpose of this study is to investigate the efficacy and safety of mechanical thrombectomy in patients with acute vertebrobasilar artery occlusion (VBAO) using the Trevo Stentriever™ device.
  
  
  METHODS
  Twenty patients diagnosed with VBAO underwent digital subtraction angiography (DSA) with the intention to perform mechanical thrombectomy with stent-retrievers between August 2011 and October 2013. Two patients were excluded because another device was primarily used; in two other patients, thrombectomy was not possible.
  
  
  RESULTS
  Thrombectomy with the Trevo device was performed in 16 patients. The Stentriever™ was used either as the sole device (56.3 %) or in conjunction with up to four additional devices or techniques. Thirty-three clot retrieval manoeuvres were performed (mean 2.1 ± 1.3, range 1-5); the device could be deployed and retrieved in all manoeuvres (100 %). No device-related complications occurred. Mean duration of the endovascular intervention was 71.8 min (±39.9; range 22-144). Complete or near complete recanalization (thrombolysis in cerebral infarction (TICI) ≥2b) was achieved in 13 patients (81.3 %). Eleven patients (68.8 %) survived and seven patients (43.8 %) showed a good clinical outcome at discharge, defined as modified Rankin Scale (mRS) 0-2 or National Institute of Health Stroke Scale (NIHSS) improvement ≥10 points. Including the two patients in whom thrombectomy was not possible, successful recanalization, good clinical outcome and survival were achieved in 72.2, 38.9 and 61.1 %, respectively.
  
  
  CONCLUSIONS
  Thrombectomy in patients with acute VBAO using the Trevo Stentriever™-either as the sole device or in conjunction with other devices-is feasible and seems to be similarly effective and safe as in the anterior circulation compared to reported data in the literature.
authors.affiliation: Department of Neuroradiology, University Hospital Leipzig, 04103, Leipzig, Germany, matthias.gawlitza@medizin.uni-leipzig.de.
authors.forename: Matthias
authors.initials: M
authors.lastname: Gawlitza
authors.forename: Dominik
authors.initials: D
authors.lastname: Fritzsch
authors.forename: Ulf
authors.initials: U
authors.lastname: Quäschling
authors.forename: Carsten
authors.initials: C
authors.lastname: Hobohm
authors.forename: Karl-Titus
authors.initials: KT
authors.lastname: Hoffmann
authors.forename: Donald
authors.initials: D
authors.lastname: Lobsien
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D020767:Intracranial Thrombosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017131:Thrombectomy / Q000295:instrumentation*; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*