Endovascular revascularization for symptomatic sub-acute and chronic intracranial vertebrobasilar artery occlusion / 中华放射学杂志

ABSTRACT

Objective To evaluate the technical feasibility,safety and treatment effect of endovascular revascularization of symptomatic sub-acute and chronic intracranial vertebrobasilar artery occlusion.Methods Twenty-one consecutive patients with symptomatic sub-acute and chronic intracranial vertebrobasilar occlusion underwent endovascular revascularization.Perioperative complications and recurrent events during the follow-up period were recorded. The modified Rankin scale ( mRS ) scores and blood stream thrombolysis in myocardial infarction (TIMI) scores for all patients preoperatively,postoperatively and at follow-up were evaluated.The results were analyzed using Wilcoxon rank sum test and Fisher exact test.Results All 21 patients but 1 (95.2％,20/21 ) obtained successful recanalization. After the procedure,9 patients showed improvements,10 were stable,and 2 worse. The decline of median mRS scores,which was 4 preoperatively [ inter-quartile range ( IR ) 2.5-5.0 ] and 4 ( IR 1.0-5.0 ) on discharge from the hospital respectively,showed significant statistical difference (Z =2.810,P ＜ 0.01 ).Three ( 14.3％ ) patients suffered periprocedural complications,namely basal arterial dissection,intra-stent thrombosis and postoperatively acute occlusion in each one.There was no death,stoke or recurrent transient ischemic attack (TIA) occurring 30 days after the procedure. During the 7 months after operation,which was the mean clinical follow-up duration,TIA and recurrent stoke occurred in one patient respectively,and two patients died of systemic complications. The median mRS scores were 2.0 (IR 1.0-4.0 )in all 21 patients and 1 ( IR 1.0-4.0) in the surviving subjects.Conclusions Endovascular revascularization for the recanalization of symptomatic sub-acute and chronic vertebrobasilar artery occlusion is technically feasible,and helps to prevent ischemic events and improve disability recovery. However,its exact effect needs further verification by future random controlled studies.