Outcome and recanalization rate of tandem basilar artery occlusion treated by mechanical thrombectomy - 16/10/20
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| pages | 6 |
| Iconographies | 3 |
| Vidéos | 0 |
| Autres | 0 |
Graphical abstract |
Highlights |
• | Basilar artery occlusion accounts for 1% of all acute ischemic stroke and 5-10% of those with large vessel occlusions. |
• | Tandem basilar artery occlusion is a concomitant basilar artery and extracranial dominant vertebral artery occlusion. |
• | Patients with tandem basilar artery occlusion had lower rates of successful recanalization and good clinical outcome. |
• | Mortality rate was higher among patients with tandem basilar artery occlusion. |
Abstract |
Background |
Tandem basilar artery occlusions (tBAO) are defined as concomitant basilar artery and extracranial dominant vertebral artery occlusions. The prognosis of such tBAO treated by mechanical thrombectomy (MT) has been scantly reported.
The purpose of our study was to compare the safety and effectiveness of MT for patients with tBAO compared to those with non-tandem basilar artery occlusions (ntBAO).
Patients and methods |
Retrospective analysis of a database of patients who underwent MT at two academic centres. All patients treated for BAO were retrieved. Patients with tBAO, defined as a concomitant BAO and extracranial vertebral artery (VA) occlusion or severe stenosis ≥70% (V1 or proximal V2 segment) were compared with patients with ntBAO.
Results |
A total of 15 patients with tBAO and 74 patients with ntBAO were enrolled. Successful reperfusion (modified thrombolysis in cerebral infarction score ≥2b) was obtained in 73.3% versus 90.5% (OR = 0.29, 95%CI: 0.07–1.15), good clinical outcome (3-months modified Rankin scale ≤2) was reached by 26.7% versus 32.4% (OR = 0.76; 95% CI: 0.24–2.63) and mortality at 3-months was 46.7% versus 31% (OR = 1.94; 95%CI: 0.63–6) of patients with tBAO versus ntBAO, respectively. Two patients (13.3%) with tBAO and three (4%) with ntBAO had symptomatic intracranial haemorrhage (OR = 3.64; 95% CI: 0.55–24).
Conclusion |
Mechanical thrombectomy for patients with tandem basilar artery occlusion tends to be associated with lower rates of successful reperfusion and good clinical outcome, and higher rate of mortality. Larger multicentre studies are warranted to better precise the proper selection and management of such patients.
Le texte complet de cet article est disponible en PDF.Abbreviations : tBAO, MT, ntBAO, VA, AIS, LVO, BA, NIHSS, mRS, mTICI, BAO, SICH, DSA
Keywords : Basilar artery occlusion, Tandem, Vertebral artery occlusion, Mechanical thrombectomy, Recanalization, Outcome
Plan
Vol 47 - N° 6
P. 404-409 - novembre 2020 Retour au numéro
Article précédent
- Toward a dynamic and quantifiable study of vascular cerebral pathologies
- Brieg Dissaux, Jean-Christophe Gentric
- Mechanical thrombectomy practices in France: Exhaustive survey of centers and individual operators
- Géraud Forestier, Basile Kerleroux, Kévin Janot, François Zhu, Victor Dumas, Jean-François Hak, Eimad Shotar, Wagih Ben Hassen, Romain Bourcier, Sébastien Soize, Jérome Berge, Olivier Naggara, Hubert Desal, Grégoire Boulouis, Aymeric Rouchaud, JENI Research collaboration, R. Hanafi, V. L’Allinec, J.-B. Girot, G. Charbonnier, A. Biondi, F. Gariel, G. Marnat, J. Ognard, J.-C. Gentric, C. Barbier, E. Chabert, P. Lebedinsky, T. Tuilier, P. Thouant, P.-O. Comby, M. Mejdoubi, O. Heck, A. Kastler, V. Chalumeau, J. Caroff, T. Personnic, A. Marchal, C. Bogey, O. Eker, X. Carle, C. Dargazanli, I. Derraz, B. Gory, L. Detraz, J. Sedat, O. Zurlinden, S. Escalard, R. Fahed, A. Guedon, V. Civelli, K. Premat, F. Clarençon, E. Ducouret, N. Raynaud, S. Velasco, P.-F. Manceau, C. Paya, F. Eugene, J. Le Moa, C. Papagiannaki, M. Aggour, M. Bintner, J.-B. Veyrieres, J.S. Richter, R. Pop, A. Consoli, F. Di-Maria, C. Arteaga, J. Darcourt, C. Michelozzi, P. Guedin, D. Herbreteau, A. Le Bras
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