title: Combined Use of Mechanical Thrombectomy with Angioplasty and Stenting for Acute Basilar Occlusions with Underlying Severe Intracranial Vertebrobasilar Stenosis: Preliminary Experience from a Single Chinese Center.
abstract: OBJECTIVE
  Acute basilar occlusions have a poor prognosis without recanalization. Many have underlying severe atherosclerotic intracranial stenosis coexisting with acute thrombosis, requiring treatment of both pathologies in the same session, though technical risks may be encountered. The purpose of this study was to evaluate the technical feasibility and safety of combined treatment by using stent retrievers for the thrombosis, together with angioplasty and stent placement for the underlying stenosis.
  
  
  METHODS
  This was a retrospective review of 13 patients with basilar occlusions treated with thrombectomy by the Solitaire stent retriever and angioplasty and intracranial stent placement for underlying severe vertebrobasilar stenosis in the same session. Reperfusion was assessed in terms of the TICI score. Perioperative complications were recorded. Clinical outcomes were assessed by the NIHSS at discharge and the mRS on follow-up at 90 days.
  
  
  RESULTS
  Of the 30 patients with acute basilar artery occlusions treated with stent retrievers during the study period, 18 had coexisting severe intracranial stenosis. Thirteen patients meeting the criteria for our study received combined mechanical thrombectomy and angioplasty with stent placement. The successful recanalization rate was 100%. Distal vessel embolizations occurred in 3 patients. There were 2 mortalities. On discharge, 10 patients (77%) had an improvement in NIHSS of ≥10 points. At 90 days, 6 patients (46%) had a good functional outcome with an mRS of ≤2.
  
  
  CONCLUSIONS
  The combined use of mechanical thrombectomy with angioplasty and stent placement for acute basilar occlusions with underlying severe intracranial atherosclerotic stenosis is technically feasible and safe.
authors.affiliation: From the Department of Interventional Neurology (F.G., X.S., D.P.M., N.M., Z.R.M.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases; Center of Stroke, Beijing Institute for Brain Disorders; Beijing, China.
authors.forename: F
authors.initials: F
authors.lastname: Gao
authors.affiliation: Department of Medicine (W.T.L.), Queen Elizabeth Hospital, Hong Kong, China.
authors.forename: W T
authors.initials: WT
authors.lastname: Lo
authors.affiliation: From the Department of Interventional Neurology (F.G., X.S., D.P.M., N.M., Z.R.M.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases; Center of Stroke, Beijing Institute for Brain Disorders; Beijing, China.
authors.forename: X
authors.initials: X
authors.lastname: Sun
authors.affiliation: From the Department of Interventional Neurology (F.G., X.S., D.P.M., N.M., Z.R.M.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases; Center of Stroke, Beijing Institute for Brain Disorders; Beijing, China.
authors.forename: D P
authors.initials: DP
authors.lastname: Mo
authors.affiliation: From the Department of Interventional Neurology (F.G., X.S., D.P.M., N.M., Z.R.M.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases; Center of Stroke, Beijing Institute for Brain Disorders; Beijing, China.
authors.forename: N
authors.initials: N
authors.lastname: Ma
authors.affiliation: From the Department of Interventional Neurology (F.G., X.S., D.P.M., N.M., Z.R.M.), Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases; Center of Stroke, Beijing Institute for Brain Disorders; Beijing, China zhongrongm@163.com.
authors.forename: Z R
authors.initials: ZR
authors.lastname: Miao
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D017130:Angioplasty / Q000379:methods*; D002681:China; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D017131:Thrombectomy / Q000379:methods*; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000628:therapy*