title: Endovascular Mechanical Thrombectomy with the Solitaire Device for the Treatment of Acute Basilar Artery Occlusion.
abstract: OBJECTIVE
  To determine the safety and efficacy of endovascular treatment with the Solitaire device for acute basilar artery occlusion (ABAO) and identify factors affecting clinical outcomes.
  
  
  METHODS
  We enrolled 36 consecutive ABAO patients (aged 58.6 ± 8.10 years) who underwent mechanical thrombectomy with the Solitaire device. We analyzed baseline characteristics, mechanical thrombectomy results, and factors predicting clinical outcomes, which were assessed at 90 days.
  
  
  RESULTS
  The median prethrombectomy National Institutes of Health Stroke Scale (NIHSS) score was 25.50 (interquartile range: 21.00-29.00); the median prethrombectomy Glasgow Coma Scale (GCS) score was 8.00 (5.00-9.75). Thirty patients (83.3%) had atherosclerotic stenosis of the occluded artery, and 25 underwent angioplasty (69.4%). Recanalization was successful (Thrombolysis in Cerebral Infarction grade: 2b-3) in 34 patients (94.4%). Six symptomatic intracranial hemorrhages (16.67%) occurred. Favorable outcomes (modified Rankin scale [mRS] score: 0-2) were achieved in 27.8% patients (10/36). The overall mortality rate was 30.6% (11/36) at 90 days. On univariate analysis, low prethrombectomy GCS and high post-thrombectomy NIHSS scores were associated with poor outcomes (mRS score >2) and mortality. Prethrombectomy unconsciousness, onset-to-recanalization time > 10.5 hours, and severe stenosis were associated with poor outcomes. Age ≥ 60 years was associated with mortality.
  
  
  CONCLUSIONS
  Endovascular treatment with the Solitaire device yielded high recanalization rates in ABAO patients and favorable clinical outcomes in approximately one third of patients. Intracranial stenosis was the main cause of occlusion. Angioplasty was commonly performed during mechanical thrombectomy to improve recanalization and prognosis. Early recanalization and better prethrombectomy status predicted better outcomes.
authors.affiliation: Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China.
authors.forename: Xiaochuan
authors.initials: X
authors.lastname: Huo
authors.affiliation: Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China.
authors.forename: Feng
authors.initials: F
authors.lastname: Gao
authors.affiliation: Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China.
authors.forename: Xuan
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China.
authors.forename: Ning
authors.initials: N
authors.lastname: Ma
authors.affiliation: Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China.
authors.forename: Ligang
authors.initials: L
authors.lastname: Song
authors.affiliation: Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China.
authors.forename: Dapeng
authors.initials: D
authors.lastname: Mo
authors.affiliation: Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China.
authors.forename: Lian
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China.
authors.forename: Bo
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China.
authors.forename: Xuelei
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China. Electronic address: doctorzhongrongm@126.com.
authors.forename: Zhongrong
authors.initials: Z
authors.lastname: Miao
mesh_terms: D000208:Acute Disease; D001157:Arterial Occlusive Diseases / Q000401:mortality / Q000601:surgery*; D001488:Basilar Artery / Q000601:surgery*; D057510:Endovascular Procedures / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000401:mortality / Q000601:surgery; D011446:Prospective Studies; D012720:Severity of Illness Index; D017131:Thrombectomy / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000401:mortality / Q000601:surgery*
keywords: Acute basilar artery occlusion; Mechanical thrombectomy; Solitaire device