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Endovascular treatment of acute basilar artery occlusion: Outcomes, influencing factors and imaging characteristics from the Tama-REgistry of acute thrombectomy (TREAT) study.
Kaneko, Junya; Ota, Takahiro; Unemoto, Kyoko; Shigeta, Keigo; Inoue, Masato; Aoki, Rie; Jimbo, Hiroyuki; Ichijo, Masahiko; Arakawa, Hideki; Shiokawa, Yoshiaki; Hirano, Teruyuki.
Affiliation
  • Kaneko J; Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan. Electronic address: kanekoj@nms.ac.jp.
  • Ota T; Department of Neurosurgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.
  • Unemoto K; Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan.
  • Shigeta K; Department of Neurosurgery, National Hospital Organization Disaster Medical Center, Tokyo, Japan.
  • Inoue M; Department of Neurosurgery, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan.
  • Aoki R; Department of Neurosurgery, Tokai University Hachioji Hospital, Tokyo, Japan.
  • Jimbo H; Department of Neurosurgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
  • Ichijo M; Department of Neurology, Musashino Red Cross Hospital, Tokyo, Japan.
  • Arakawa H; Department of Neurosurgery, Omori Red Cross Hospital, Tokyo, Japan.
  • Shiokawa Y; Department of Neurosurgery, Kyorin University, Tokyo, Japan.
  • Hirano T; Department of Stroke and Cerebrovascular Medicine, Kyorin University, Tokyo, Japan.
J Clin Neurosci ; 86: 184-189, 2021 Apr.
Article in En | MEDLINE | ID: mdl-33775325
ABSTRACT

OBJECTIVE:

The effectiveness of mechanical thrombectomy (MT) for acute basilar artery occlusion (ABAO) remains unknown. We evaluated the feasibility, safety, and efficacy of endovascular treatment for ABAO.

METHODS:

We retrospectively investigated patients with ABAO who underwent MT using modern stent retrievers and an aspiration device between January 2015 and March 2019 at 12 comprehensive stroke centers. Functional outcomes and 90-day mortality rates were analyzed as primary outcomes. Factors influencing outcomes were analyzed as secondary outcomes. Relationships between outcome and affected area of infarction on arrival were also analyzed.

RESULTS:

Seventy-three patients were included. Good outcome (modified Rankin Scale (mRS) score 0-2) was achieved in 25/73 patients (34.2%) and the all-cause 90-day mortality rate was 23.3% (17/73). Successful recanalization (modified Thrombolysis In Cerebral Infarction grade 2b and 3) was achieved in 70/73 patients (95.9%). In univariate analyses, age, National Institutes of Health Stroke Scale score, and posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS) differed significantly between good and poor functional outcome groups. Age and pc-ASPECTS were significantly associated with functional outcomes in the logistic regression model. Positive findings for the midbrain on diffusion-weighted imaging on pc-ASPECTS and brainstem score were significantly associated with poor outcomes.

CONCLUSION:

MT with modern devices for ABAO resulted in highly successful recanalization and good outcomes. A positive finding for the midbrain on initial imaging might predict poor outcomes. Further studies are required to confirm our results.
Subject(s)
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Vertebrobasilar Insufficiency / Registries / Thrombectomy / Endovascular Procedures Type of study: Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Aged / Aged80 / Female / Humans / Male / Middle aged Language: En Journal: J Clin Neurosci Journal subject: NEUROLOGIA Year: 2021 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Vertebrobasilar Insufficiency / Registries / Thrombectomy / Endovascular Procedures Type of study: Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Aged / Aged80 / Female / Humans / Male / Middle aged Language: En Journal: J Clin Neurosci Journal subject: NEUROLOGIA Year: 2021 Document type: Article
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