title: Intermediate Catheters Reduce the Length of Mechanical Thrombectomy Procedures in Acute Basilar Artery Occlusions.
abstract: OBJECTIVE
  In the past years, technical developments have raised recanalization rates of endovascular treatments of intracerebral artery occlusions in acute ischemic stroke. By using stent retrievers, several prospective trials have reported recanalization rates up to 79 % as well as good neurological outcome in up to 58 % of the cases. The degree of the recanalization and the length of the procedure are factors known to influence the clinical outcome of patients treated endovascularly. Yet, still little is known about factors influencing the angiographic results of thrombectomy procedures. The purpose of this study was to investigate whether the use of intermediate catheters affects the angiographic results of thrombectomy procedures in basilar artery occlusions.
  
  
  METHODS
  A total of 47 consecutive patients with acute basilar artery occlusions who underwent endovascular treatment with stent retrievers in our department were retrospectively identified. We analyzed the angiographic data regarding the use of intermediate catheters, the lengths of the procedures, the number of passes of the stent retrievers, the angiographic results, and the site of access to the basilar artery.
  
  
  RESULTS
  Recanalization with modified thrombolysis in cerebral infarction (mTICI) ≥ 2b was achieved in 74.5 %. Intermediate catheters were used in 13 cases. The mean length of the procedures was significantly shorter when intermediate catheters were used (44.8 ± 27.6 vs. 70.7 ± 41.4 min, P = .043). There were no significant differences in the number of passes or in the final mTICI scores.
  
  
  CONCLUSIONS
  The use of intermediate catheters significantly reduces the length of mechanical thrombectomy procedures in acute basilar artery occlusions.
authors.affiliation: Department of Neuroradiology, Saarland University Hospital, Kirrberger Str., 66424, Homburg/Saar, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Mühl-Benninghaus
authors.affiliation: Department of Neuroradiology, Saarland University Hospital, Kirrberger Str., 66424, Homburg/Saar, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Körner
authors.affiliation: Department of Neuroradiology, Saarland University Hospital, Kirrberger Str., 66424, Homburg/Saar, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Simgen
authors.affiliation: Department of Neuroradiology, Saarland University Hospital, Kirrberger Str., 66424, Homburg/Saar, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Reith
authors.affiliation: Department of Neuroradiology, Saarland University Hospital, Kirrberger Str., 66424, Homburg/Saar, Germany. umut.yilmaz@uks.eu.
authors.forename: U
authors.initials: U
authors.lastname: Yilmaz
mesh_terms: D000368:Aged; D057785:Catheters / Q000706:statistics & numerical data*; D002533:Cerebral Angiography / Q000706:statistics & numerical data*; D003131:Combined Modality Therapy / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D061185:Mechanical Thrombolysis / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data*; D008875:Middle Aged; D061646:Operative Time; D015995:Prevalence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery*
keywords: Basilar artery occlusions; Mechanical thrombectomy; Stent retrievers