title: Endovascular treatment of severe acute basilar artery occlusion.
abstract: Severe acute basilar artery occlusion (BAO) has a high mortality rate but as yet no effective treatment has been developed. This study aimed to evaluate the feasibility and safety of combined mechanical thrombectomy, intra-arterial thrombolysis, and emergent stent placement for patients with severe acute BAO. Eighteen patients who were unconscious after confirmed onset of BAO and who were given arterial interventional treatment from March 2011 to June 2013 at our department were included in this study. The mean age was 59.56 years (range: 31-76 years) and patients were in a critical physical condition upon admission, and had a mean National Institutes of Health Stroke Scale (NIHSS) score of 25.94 (range: 18-35). All patients were treated with mechanical thrombectomy, 10 of whom received mechanical thrombectomy only. Of the others, eight were also treated with intra-arterial thrombolysis, three were treated with emergent stent placement, and 17 were treated with recanalization with an achieved recanalized rate of 94.4%. The average number of passes through the stent was 1.5 (range: 1-3) and five patients died (27.8%). Thirteen patients survived, and the mean NIHSS score was 6.54 (range: 0-16). Seven patients showed a modified Rankin Scale score ⩽ 2, and the rate of good prognoses was 38.9%. In the treatment of patients with severe acute BAO, intra-arterial mechanical thrombectomy combined with thrombolysis or stent placement are effective strategies to restore blood flow and preserve life, and these strategies have a low incidence of complications.
authors.affiliation: Department of Neurosurgery, Tianjin 5th Center Hospital, 41 Zhenjiang Road, Tanggu District, Tianjin 300450, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Tianjin 5th Center Hospital, 41 Zhenjiang Road, Tanggu District, Tianjin 300450, China.
authors.forename: Wanchao
authors.initials: W
authors.lastname: Shi
authors.affiliation: Department of Neurosurgery, Tianjin 5th Center Hospital, 41 Zhenjiang Road, Tanggu District, Tianjin 300450, China.
authors.forename: Zhiguo
authors.initials: Z
authors.lastname: Su
authors.affiliation: Department of Neurosurgery, Tianjin 5th Center Hospital, 41 Zhenjiang Road, Tanggu District, Tianjin 300450, China.
authors.forename: Xiaozhi
authors.initials: X
authors.lastname: Liu
authors.affiliation: Center for Cerebrovascular Research, Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Hua
authors.initials: H
authors.lastname: Su
authors.affiliation: Department of Chemistry and Biochemistry, University of Delaware, Newark, DE, USA.
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, Tianjin 5th Center Hospital, 41 Zhenjiang Road, Tanggu District, Tianjin 300450, China. Electronic address: wjzhenlin817@sina.com.
authors.forename: Zhenlin
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Lawton
mesh_terms: D000328:Adult; D000368:Aged; D002544:Cerebral Infarction / Q000601:surgery / Q000628:therapy; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000191:economics / Q000379:methods; D057510:Endovascular Procedures / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015607:Stents / Q000009:adverse effects / Q000191:economics; D020521:Stroke / Q000601:surgery / Q000628:therapy; D016019:Survival Analysis; D017131:Thrombectomy / Q000009:adverse effects / Q000191:economics / Q000379:methods; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000191:economics / Q000379:methods; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000191:economics / Q000401:mortality / Q000601:surgery*
chemical_list: D010959:Tissue Plasminogen Activator
keywords: Acute basilar artery occlusion; Emergent stent placement; Intra-arterial thrombolysis; Thrombectomy