Endovascular Revascularization for Basilar Artery Occlusion

Abstract

Basilar artery occlusion is one of the most devastating neurological conditions known to man. Though rare, patients with clinical syndromes localized to this anatomical region are often referred to acute stroke and endovascular units. Recent studies evaluating the efficacy of endovascular approaches to stroke have focused on anterior circulation syndromes. In this review, we examine the approaches to stroke syndromes due to basilar artery thrombosis. We share the relevant data for intravenous and intra-arterial tissue plasminogen activator as well as mechanical approaches to restoring perfusion in this critical area of the brain. i 2014 S. Karger AG, Basel

Endovascular therapy in acute basilar artery occlusion: A retrospective single‐centre Australian analysis

“…Recent studies have demonstrated that good clinical outcomes in large vessel occlusion are linked to rapid diagnosis and restoration of blood flow . Success of intravenous and intra‐arterial thrombolysis in BAO is variable, leading to Endovascular Therapy (EVT) being utilized to a greater degree in this clinical setting . However, further evidence in the use of EVT in posterior circulation strokes is required.…”

Mechanical thrombectomy with the Solitaire AB stent for treatment of acute basilar artery occlusion: A single-center experience

“…BAO also has the highest mortality rate of all types of ischemic stroke [1], with a morbidity and mortality rate of acute BAO of 80-90% without active intervention [2].…”

“…Intra-arterial thrombolysis (IAT) is another pharmacologic thrombolysis method. However, the efficacy of IA compared with IV therapy for treatment of acute BAO remains unclear owing to a lack of randomized controlled trials (RCT) [2]. According to a systematic review of BAO, the incidence of mortality or dependency are similar after IVT or IAT treatment [5].…”

Successful Endovascular Revascularization of Acute Basilar Artery Occlusion Approached via an Aberrant Right Subclavian Artery

“…[1][2][3] Because of the lack of prospective studies on acute BAO, the natural history, prognosis, and treatment of BAO have not been fully understood. 2,4) Generally, the treatment of acute BAO involves intravenous administration of recombinant tissue plasminogen activator (rt-PA). However, because intravenous rt-PA has been ineffective in most cases of acute BAO, endovascular treatment has become an attractive treatment modality in accordance with the development of treatment devices, such as stent retrievers.…”

“…However, because intravenous rt-PA has been ineffective in most cases of acute BAO, endovascular treatment has become an attractive treatment modality in accordance with the development of treatment devices, such as stent retrievers. 4) We encountered a patient with acute BAO who had the aortic anomaly of an aberrant right subclavian artery (ARSA) in which the right subclavian artery originated from the most distal end of the aortic arch. This particular anomaly has a high incidence among intrathoracic arterial anomalies.…”