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Updated: Jun 10, 2026
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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Reperfusion therapy for acute vertebrobasilar occlusion
1Department of Neurosurgery, Junwakai Memorial Hospital; Kamatsu, Miyazaki, Japan.
Summary
Interventional reperfusion therapy for acute vertebrobasilar occlusion achieved successful recanalization and clinical improvement in 66.7% of patients. Preoperative single photon emission computed tomography (SPECT) may guide treatment decisions for these critical cases.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Vascular Neurology
Background:
- Acute vertebrobasilar occlusion is a critical condition with high morbidity and mortality.
- Effective treatment strategies for acute vertebrobasilar occlusion remain a significant clinical challenge.
- Interventional reperfusion therapy offers a potential treatment avenue for selected patients.
Purpose of the Study:
- To evaluate the efficacy and outcomes of interventional reperfusion therapy in patients with acute vertebrobasilar occlusion.
- To assess the role of single photon emission computed tomography (SPECT) in guiding treatment decisions.
- To analyze factors influencing clinical outcomes in treated patients.
Main Methods:
- Retrospective review of 10 patients with acute vertebrobasilar occlusion.
- Nine patients received interventional reperfusion therapy (intra-arterial thrombolysis or angioplasty).
- One patient with severe presentation received conservative management; residual cerebral blood flow (CBF) assessed by SPECT in 4 patients.
Main Results:
- Successful recanalization and clinical improvement were achieved in 6 of 9 patients (66.7%) undergoing reperfusion therapy.
- SPECT findings correlated with outcomes: preserved CBF predicted successful recanalization and improvement, while reduced CBF indicated poor outcomes.
- Interventional therapy was effective in cases with progressing or fluctuating symptoms, but not in persistent deep coma.
Conclusions:
- Interventional reperfusion therapy is effective in a majority of patients with acute vertebrobasilar occlusion.
- Preoperative SPECT can be a valuable tool in determining the suitability of reperfusion therapy.
- Patient's clinical status and cerebral blood flow patterns are crucial determinants of treatment success.
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