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Thrombectomy in acute vertebrobasilar occlusion: a single-centre experience
Dong Hyuk Lee1, Seung Hwan Kim1, Hyungon Lee1
1Department of Neurosurgery, Inje University Haeundae Paik Hospital, 875, Haeun-daero, Haeundae-gu, Busan, Republic of Korea.
Neuroradiology
|February 15, 2020
Summary
Thrombectomy for acute vertebrobasilar occlusion (VBO) shows promise, with good outcomes linked to lower NIHSS scores and non-atherosclerotic causes. Stent retrievers may offer faster recanalization than catheter aspiration in VBO treatment.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Vascular Neurology
Background:
- Acute vertebrobasilar occlusion (VBO) carries a high risk of severe disability or death.
- Thrombectomy for VBO is an emerging treatment with limited reported data.
Purpose of the Study:
- To retrospectively evaluate the clinical and radiological outcomes of endovascular thrombectomy in patients with acute VBO.
- To compare the efficacy and safety of catheter aspiration versus stent retriever thrombectomy for VBO.
Main Methods:
- Retrospective analysis of 38 patients with 40 acute VBOs treated between March 2010 and December 2017.
- Thrombectomy performed using either catheter aspiration (n=11) or stent retriever (n=29).
Main Results:
- Good clinical outcomes (3-month mRS ≤ 2) were achieved in 22.5% of patients.
- Successful recanalization (TICI grade 2b or 3) was achieved in 87.5% of cases.
- Good outcomes were associated with lower NIHSS scores and non-atherosclerotic etiologies (p<0.05).
- No significant difference in clinical or radiological outcomes between aspiration and stent retriever thrombectomy (p>0.05).
- Stent retriever thrombectomy demonstrated a significantly shorter procedure time (p=0.037).
Conclusions:
- Lower admission NIHSS scores and non-atherosclerotic causes predict better clinical outcomes in VBO thrombectomy.
- Both catheter aspiration and stent retrievers are viable options for VBO thrombectomy, yielding similar results.
- Stent retrievers may offer faster recanalization compared to catheter aspiration in VBO.
