title: Outcomes of stent retriever thrombectomy in basilar artery occlusion: an observational study and systematic review.
abstract: BACKGROUND
  Basilar artery occlusion (BAO) remains one of the most devastating subtypes of stroke with high mortality and poor outcome. Early recanalisation is the most powerful predictor of favourable outcome in patients with stroke, and may be improved with mechanical thrombectomy using stent retriever devices. However, the benefit in functional outcome and safety of stent retrievers are not yet well known. The aim of this study was to assess efficacy and safety profiles of stent retriever thrombectomy in BAO patients with stroke.
  
  
  METHODS
  We analysed data retrospectively from our consecutive clinical series and conducted a systematic review and meta-analysis of all previous studies of stent retriever thrombectomy in BAO patients with stroke between November 2010 and April 2014.
  
  
  RESULTS
  From March 2010 to March 2013, 22 patients with acute BAO were treated with a Solitaire stent retriever in our series. Favourable outcome was significantly associated with younger age and distal BAO. The literature search identified 15 previous studies involving a total of 312 subjects. In the meta-analysis, including our series data, the recanalisation rate (Thrombolysis In Cerebral Infarction (TICI) score ≥ 2b) reached 81% (95% CI 73% to 87%). The rate of symptomatic intracranial haemorrhage was 4% (95% CI 2% to 8%), favourable outcome (modified Rankin Scale (mRS) ≤ 2 at 3 months) was found in 42% (95% CI 36% to 48%) and mortality rate was 30% (95% CI 25% to 36%).
  
  
  CONCLUSIONS
  Stent retriever thrombectomy is a safe treatment modality for patients with stroke presenting with BAO. Although the stent retrievers showed a good recanalisation rate, there are currently no randomised clinical trials to assess its clinical efficacy in comparison with the reference treatment.
authors.affiliation: Department of Interventional Neuroradiology, Hôpital Neurologique Pierre Wertheimer, Bron, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Gory
authors.affiliation: Department of Interventional Neuroradiology, Hôpital Neurologique Pierre Wertheimer, Bron, France.
authors.forename: Islam
authors.initials: I
authors.lastname: Eldesouky
authors.affiliation: Department of Interventional Neuroradiology, Hôpital Neurologique Pierre Wertheimer, Bron, France.
authors.forename: Rotem
authors.initials: R
authors.lastname: Sivan-Hoffmann
authors.affiliation: Department of Biostatitics, UMR 5558, Hospices Civils de Lyon, Lyon, France.
authors.forename: Murielle
authors.initials: M
authors.lastname: Rabilloud
authors.affiliation: Department of Neurology, Stroke Unit, Hôpital Neurologique Pierre Wertheimer, Bron, France.
authors.forename: Elodie
authors.initials: E
authors.lastname: Ong
authors.affiliation: Department of Interventional Neuroradiology, Hôpital Neurologique Pierre Wertheimer, Bron, France.
authors.forename: Roberto
authors.initials: R
authors.lastname: Riva
authors.affiliation: Department of Interventional Neuroradiology, Hôpital Neurologique Pierre Wertheimer, Bron, France.
authors.forename: Dorin Nicolae
authors.initials: DN
authors.lastname: Gherasim
authors.affiliation: Department of Interventional Neuroradiology, Hôpital Neurologique Pierre Wertheimer, Bron, France.
authors.forename: Alexis
authors.initials: A
authors.lastname: Turjman
authors.affiliation: Department of Neurology, Stroke Unit, Hôpital Neurologique Pierre Wertheimer, Bron, France.
authors.forename: Norbert
authors.initials: N
authors.lastname: Nighoghossian
authors.affiliation: Department of Interventional Neuroradiology, Hôpital Neurologique Pierre Wertheimer, Bron, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Turjman
mesh_terms: D006801:Humans; D012189:Retrospective Studies; D015607:Stents; D020521:Stroke / Q000150:complications / Q000401:mortality / Q000601:surgery; D017131:Thrombectomy / Q000379:methods* / Q000401:mortality; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000150:complications / Q000401:mortality / Q000601:surgery*
keywords: CEREBROVASCULAR DISEASE; STROKE; SYSTEMATIC REVIEWS