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.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1136/jnnp-2014-310250 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Outcomes and Complications Associated with Mechanical Thrombectomy in the Treatment of Acute Ischemic Stroke.
Cardiol Cardiovasc Med
December 2024
Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona CA 91766, USA.
Universally, stroke presents as neurological deficits due to the obstruction of blood supply to specific regions of the brain. Among the three main categories of stroke, acute ischemic stroke is the leading cause of death and disability worldwide. As of today, there are two effective treatment methods: thrombolysis and endovascular therapy.
View Article and Find Full Text PDFDual-stent thrombectomy for recanalization of cerebral embolism caused by infective endocarditis: a case report.
Front Neurol
December 2024
Department of Neurology, The Second People's Hospital of Liaocheng, The Second Hospital of Liaocheng Affiliated to Shandong First Medical University, Linqing, China.
Methods: In this case report, we present an in-depth narrative of a patient who was subjected to mechanical thrombectomy (MT) for an obstruction in the main trunk and bifurcation of the left middle cerebral artery subsequent to Infective Endocarditis (IE). Initial intervention using a solitary-stent technique proved to be ineffective; thus, we shifted to a dual-stent strategy, which successfully recanalized the compromised blood vessel.
Results: The dual-stent retriever method can be especially advantageous for treating persistent clots that occur at arterial bifurcations resisting the efforts of a single-stent retriever during the MT process.
Randomized Study Comparing First-Line Dual Versus Single-Stent Retriever Technique: TWIN2WIN.
Stroke
December 2024
Stroke Research Group, Vall d'Hebron Research Institute, Barcelona, Universitat Autonoma de Barcelona, Spain (A.T., M.J., J.C., F.D., D.H., M.d.D., M. Rubiera, A.G.-T., F.R., M.O., M.R.-G., C.M., M. Ribo).
Background: The double-stent retriever (SR) technique has been described as an effective rescue technique when single-SR fails to induce recanalization. We aimed to assess the safety and efficacy of first-line double-SR in patients with stroke undergoing thrombectomy.
Methods: This was a multicenter, randomized, controlled, blinded adjudicated primary outcome study.
Macrowire for Intracranial Thrombectomy: A Video Description.
Interv Neuroradiol
December 2024
Department of Neurology, Neurological Surgery and Radiology, Indiana University School of Medicine, Indianapolis, IN, USA.
Mechanical thrombectomy has become the cornerstone to achieve reperfusion in large vessel occlusion causing acute ischemic stroke. Since the advent of intracranial thrombectomy, the procedural setup has been to deliver aspiration catheter over microwire and microcatheter to the intracranial occlusion (ADAPT) or to deliver the stent-retriever through the microcatheter (SOLUMBRA) to perform thrombectomy. In both these techniques the quintessential aspect is crossing the clot/thrombus, which increases the chances of clot fragmentation or disruption.
View Article and Find Full Text PDF[Endovascular thrombectomy of medium vessel occlusions].
Radiologie (Heidelb)
December 2024
Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum des Saarlandes, Kirrberger Straße, 66421, Homburg/Saar, Deutschland.
Background: Acute ischemic stroke is a leading cause of disability and dependency in daily life. While endovascular therapy has become the standard treatment for large vessel occlusions, its benefit for medium vessel occlusions has not yet been clearly established.
Objective: This article provides an overview of the current evidence, epidemiology, and clinical challenges of thrombectomy in distal medium vessel occlusions (DMVOs).
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!