Endovascular treatment of acute basilar artery occlusion: Tama-REgistry of Acute Thrombectomy (TREAT) study

Published:April 12, 2019DOI:https://doi.org/10.1016/j.jns.2019.04.010

      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 December 2017 at 12 comprehensive stroke centers. Functional outcomes and 90-day mortality were analyzed as primary outcomes.

      Results

      Forty-eight patients were included. Good outcome (modified Rankin Scale mRS 0–2) was achieved in 20/48 patients and the all-cause 90-day mortality rate was 25%. Successful recanalization (modified Thrombolysis In Cerebral Infarction [mTICI] grade 2b and 3) was achieved in 47/48 patients. National Institutes of Health Stroke Scale, posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS), DWI Brain Stem Score, mTICI (3 > 2b), and intracranial hemorrhage were significantly different between good and poor functional outcome groups. The occlusion site of BA was significantly different between patients with moderate outcome (mRS 0–3) versus others. We found that age, pc-ASPECTS and mTICI were significantly associated with functional outcomes in the logistic regression model.

      Conclusion

      MT with stent retrievers and an aspiration device for ABAO results in high successful recanalization and good outcomes. Further studies are required to confirm our results.

      Abbreviations:

      ABAO (acute basilar artery occlusion), BASICS (Basilar Artery Intervention Cooperation Study), BSS (Brain Stem Score), CTA (computed tomography angiography), DWI (diffusion-weighted image), IAT (intra-arterial therapy), ICH (intracranial hemorrhage), IVT (intra-venous therapy), LVO (large vessel occlusion), MRA (magnetic resonance angiography), MT (mechanical thrombectomy), mTICI (modified Thrombolysis In Cerebral Infarction), OTR (onset to recanalization), pc-ASPECTS (posterior circulation Alberta Stroke Program Early CT Score), RCT (randomized clinical trials), rtPA (recombinant tissue plasminogen activator), TREAT (Tama-REgistry of Acute Thrombectomy)

      Keywords

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