A Comparison between Mechanical Thrombectomy and Intra-arterial Fibrinolysis in Acute Basilar Artery Occlusion: Single Center Experiences.
OBJECTIVE
Recent advances in intra-arterial techniques and thrombectomy devices lead to high rate of recanalization. However, little is known regarding the effect of the evolvement of endovascular revascularization therapy (ERT) in acute basilar artery occlusion (BAO). We compared the outcome of endovascular mechanical thrombectomy (EMT) versus intra-arterial fibrinolysis (IAF)-based ERT in patients with acute BAO.


METHODS
After retrospectively reviewed a registry of consecutive patients with acute ischemic stroke who underwent ERT from September 2003 to February 2015, 57 patients with acute BAO within 12 hours from stroke onset were enrolled. They were categorized as an IAF group (n=24) and EMT group (n=33) according to the primary technical option. We compared the procedural and clinical outcomes between the groups.


RESULTS
The time from groin puncture to recanalization was significantly shorter in the EMT group than in the IAF group (48.5 [25.3 to 87.8] vs. 92 [44 to 179] minutes; P=0.02) The rate of complete recanalization was significantly higher in the EMT group than in the IAF group (87.9% vs 41.7%; P<0.01). The good outcome of the modified Rankin Scale score≤2 at 3 months was more frequent in the EMT group than in the IAF group, but it was not statistically significant (39.4% vs 16.7%; P=0.06).


CONCLUSIONS
EMT-based ERT in patients with acute BAO is superior to IAF-based ERT in terms of the reduction of time from groin puncture to recanalization and the improvement of the rate of complete recanalization.
Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.|Department of Neurology, Gyeongsang National University Changwon Hospital, Changwon, Korea.
Seunguk
S
Jung
Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
Cheolkyu
C
Jung
Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
Yun Jung
YJ
Bae
Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
Byung Se
BS
Choi
Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
Jae Hyoung
JH
Kim
Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.
Sang-Hwa
SH
Lee
Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.|Department of Neurology, Gyeongsang National University Changwon Hospital, Changwon, Korea.
Jun Young
JY
Chang
Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.
Beom Joon
BJ
Kim
Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.
Moon-Ku
MK
Han
Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.
Hee-Joon
HJ
Bae
Department of Radiology, Myongji Hospital, Goyang, Korea.
Bae Ju
BJ
Kwon
Department of Radiology, Chungbuk National University College of Medicine, Cheongju, Korea.
Sang-Hoon
SH
Cha
Basilar artery; Cerebral infarction; Thrombectomy; Thrombolytic therapy