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Rigshospitalet - en del af Københavns Universitetshospital
Udgivet

Mechanical thrombectomy in basilar artery thrombosis: technical advances and safety in a 10-year experience

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  • Gunther Fesl
  • Markus Holtmannspoetter
  • Maximilian Patzig
  • Thomas E Mayer
  • Thomas Pfefferkorn
  • Hartmut Brueckmann
  • Gernot Schulte-Altedorneburg
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PURPOSE: Multiple endovascular devices have been used for mechanical thrombectomy (MT) in basilar artery occlusion (BAO) for >10 years. Based on a single-center experience during the course of one decade, we present data on safety and efficacy of previous MT devices compared with modern stent retriever and suction thrombectomy.

MATERIALS AND METHODS: Eighty-one patients (29 women, 52 men, mean age 61.5 years, range 17-90) with angiographically confirmed BAO that had been treated by MT between 2001 and 2011 were retrospectively evaluated. Patients in group 1 (n = 60) had been treated between 2001 and 2008 with different devices available at that time. Patients in group 2 (n = 21) had been treated by modern stent retriever or local suction devices between 2008 and 2011. Recanalization rate, needle to recanalization time, procedure-related complications, and distal embolization of thrombotic material were recorded and compared.

RESULTS: Recanalization rates of 95% were high in both groups. Procedure-related dissection (n = 5) and subarachnoid hemorrhage (n = 9) occurred in group 1 but not in group 2 (p < 0.016). Needle-to-recanalization time was less than half in group 2 compared with group 1 (54.6 vs. 132.3 min, p < 0.01). Frequency of distal embolization was comparable in both groups (47%).

CONCLUSION: High recanalization rates have been achieved since the introduction of MT in BAO. However, modern stent retriever and suction devices allow for safer and more rapid recanalization compared with previous MT devices.

OriginalsprogEngelsk
TidsskriftCardiovascular and Interventional Radiology
Vol/bind37
Udgave nummer2
Sider (fra-til)355-61
Antal sider7
ISSN0174-1551
DOI
StatusUdgivet - apr. 2014

ID: 45967350