Endovascular treatment of tandem occlusions in vertebrobasilar stroke: technical aspects and outcome compared with isolated basilar artery occlusion.

Piechowiak, Eike I.; Kaesmacher, Johannes; Zibold, Felix; Dobrocky, Tomas; Mosimann, Pascal J.; Jung, Simon; Fischer, Urs; Arnold, Marcel; Bellwald, Sebastian; Heldner, Mirjam R.; Gralla, Jan; Mordasini, Pasquale (2019). Endovascular treatment of tandem occlusions in vertebrobasilar stroke: technical aspects and outcome compared with isolated basilar artery occlusion. (In Press). Journal of neurointerventional surgery BMJ Publishing Group 10.1136/neurintsurg-2019-014825

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BACKGROUND AND PURPOSE Acute basilar artery occlusion (BAO) is a devastating disease with a high rate of mortality and morbidity, and early recanalization is crucial to achieve a good prognosis. The best treatment strategy for BAO combined with a proximal stenosis (tandem occlusion) is not yet clear. Our study aimed to evaluate whether and how vertebrobasilar tandem occlusions can be treated effectively and safely compared with isolated BAO. MATERIALS AND METHODS Fifty-two patients with acute vertebrobasilar occlusive stroke treated with mechanical thrombectomy were identified in a prospective database from March 2010 to September 2016. We retrospectively analysed the clinical, technical, and functional outcomes of the patients. RESULTS Of the 52 patients, 15 presented with a tandem occlusion, 14 with a single intracranial occlusion due to an underlying stenosis, and 23 with a single embolic BAO. Successful recanalization was achieved in all of the patients with tandem occlusions (modified Thrombolysis in Cranial Infarction 2b/3) and in 35 of 37 patients with a single BAO (with and without stenosis). A favourable outcome was achieved (modified Rankin Scale ≤2) in 8 of the 15 patients with a tandem occlusion compared with 4 of the 14 patients with a single BAO with underlying stenosis and 5 of the 23 patients with isolated embolic BAO (p=0.18). CONCLUSIONS We suggest that endovascular treatment of vertebrobasilar tandem occlusions is safe and feasible, with a high rate of good outcome.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Piechowiak, Eike Immo; Kaesmacher, Johannes; Zibold, Felix; Dobrocky, Tomas; Mosimann, Pascal John; Jung, Simon; Fischer, Urs; Arnold, Marcel; Bellwald, Sebastian; Heldner, Mirjam Rachel; Gralla, Jan and Mordasini, Pasquale

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1759-8486

Publisher:

BMJ Publishing Group

Language:

English

Submitter:

Maria de Fatima Henriques Bernardo

Date Deposited:

18 Jul 2019 10:17

Last Modified:

18 Jul 2019 10:17

Publisher DOI:

10.1136/neurintsurg-2019-014825

PubMed ID:

31113810

Uncontrolled Keywords:

artery stroke technique

BORIS DOI:

10.7892/boris.131168

URI:

https://boris.unibe.ch/id/eprint/131168

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