title: Endovascular mechanical thrombectomy in basilar artery occlusion: variables affecting recanalization and outcome.
abstract: Ischemic stroke due to basilar artery occlusion (BAO) is frequently associated with a poor prognosis. To date the most effective therapeutic approach has not been established and little is known about the predictors of clinical outcome. The aim of this study was to describe safety and efficacy of intra-arterial mechanical thrombectomy (IAMT) through latest generation devices in patients with BAO, focusing on those variables that may affect recanalization and clinical outcome. We analyzed retrospectively a series of 32 patients with BAO who underwent IAMT. We assessed the association of some clinical and neuroradiological features with recanalization rate and clinical outcome. Successful recanalization was achieved in 28 out of 32 patients (87.5 %). Symptomatic intracerebral hemorrhage (SICH) was observed in 2/32 patients (6.3 %) and mortality in the first 3 months was 25.0 %. At 3-month follow up evaluation, 13/32 patients (40.6 %) showed a good functional outcome (mRS score ≤2). There were no statistical differences in term of age, gender, risk factors, cause of stroke, recanalization rate, pre-treatment pc-ASPECTS score and SICH frequencies between patients with favorable and unfavorable outcome. Increased length of thrombi was associated with unfavorable clinical outcome at 3 months. Recanalization rate was not affected by any of the variables considered. In BAO, IAMT through newest generation devices has high recanalization rates and low complication frequencies. Length of BAO is an important predictor of clinical outcome.
authors.affiliation: Stroke Unit, Neurologia Vascolare, Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy. nicgilbe@tin.it.
authors.forename: Nicola
authors.initials: N
authors.lastname: Gilberti
authors.affiliation: Stroke Unit, Neurologia Vascolare, Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Gamba
authors.affiliation: Stroke Unit, Neurologia Vascolare, Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Premi
authors.affiliation: Stroke Unit, Neurologia Vascolare, Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Costa
authors.affiliation: Stroke Unit, Neurologia Vascolare, Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Vergani
authors.affiliation: Stroke Unit, Neurologia Vascolare, Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy.
authors.forename: Ilenia
authors.initials: I
authors.lastname: Delrio
authors.affiliation: Stroke Unit, Neurologia Vascolare, Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Spezi
authors.affiliation: Neuroradiologia, Università degli Studi di Brescia, Brescia, Italy.
authors.forename: Dikran
authors.initials: D
authors.lastname: Mardighian
authors.affiliation: Neuroradiologia, Università degli Studi di Brescia, Brescia, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Frigerio
authors.affiliation: Neuroradiologia, Università degli Studi di Brescia, Brescia, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gasparotti
authors.affiliation: Clinica Neurologica, Università degli Studi di Brescia, Brescia, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Padovani
authors.affiliation: Stroke Unit, Neurologia Vascolare, Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Magoni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001488:Basilar Artery / Q000473:pathology / Q000601:surgery; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D017131:Thrombectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000601:surgery*
keywords: Acute ischemic stroke; Basilar artery; Endovascular thrombectomy; Stroke treatment