Mechanical thrombectomy with the Solitaire AB revascularization device in acute basilar artery occlusion: initial experience / 中华放射学杂志

ABSTRACT

Objective To explore and evaluate the efficacy and safety of mechanical thrombectomy with the Solitaire AB Revascularization Device in acute basilar artery occlusion.Methods Nine patients with basilar artery occlusion were treated with direct thrombectomy by using Solitaire AB stent retrievers between August 2010 and October 2012.Stent angioplasty was performed for patients with serious residual stenosis.Neurologic status was evaluated before and after treatment according to the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin scales (mRs).Neurologic status was evaluated after treatment according to the NIHSS and mRs 6 months after stent placement.Stent patency at follow-up was assessed by MR angiography,or DSA 6 months after stent placement.Results Successful revascularization was achieved in all patients.Stenting and angioplasty were performed in 6 patients with serious residual stenosis.The complication of cerebral hemorrhage did not occur in any patient.Acute thrombosis happened in one patient one day after procedure.Emergent angiography showed re-occlusion of basilar artery.Intraarterial thrombolytic therapy was given,and reperfusion was achieved,but the patient died 6 days later.One patient developed coma at 4th month of follow-up.MRA showed acute basilar artery occlusion again and magnetic resonance imaging showed extensive ischemic damage of the brainstem.The patient died during the conservative treatment period.The mean NIHSS scores were 2.4 ± 1.2 at discharge.The mRs scores were 0 in 2 patients,1 in 4 patients,2 in one patient,and 3 in 1 patient at discharge.Conclusion Mechanical thrombectomy with the Solitaire AB stent in acute basilar artery occlusion is relatively safe and effective.