Intraarterial Thrombolysis and Stent Placement for Acute Basilar Artery Occlusion

Yao-Yu, Yu; Niu, Le; Gao, Li; Zhao, Zhenwei; Deng, Jianping; Qu, Yue; Jiao, De-rang; Yuan, Jinqing; Gao, Guodong

doi:10.1016/j.jvir.2010.05.017

Cited by 14 publications

(6 citation statements)

References 20 publications

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“…placement. 25,26 in the present study, partial or complete recanalization was observed in 26.6% of patients treated with iVt, 88.2% of patients treated with iVt+iat, and 90.0% of patients treated with iat. an apparent, although statistically insignificant trend for better clinical outcome was observed in patients treated with combination of iVt and iat in the present study.…”

Section: Discussionsupporting

confidence: 52%

Outcome Predictors in Acute Basilar Artery Occlusion

Dorňák¹,

Herzig²,

Školoudík³

et al. 2014

Can. J. Neurol. Sci.

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368Basilar artery occlusion (Bao) is an infrequent form of acute ischemic stroke (aiS). this particular type of stroke occurs in approximately 1% of all-cause cases and is reported in approximately 8% of patients with symptomatic vertebrobasilar territory ischemia.1,2 Basilar artery occlusion symptoms are heterogeneous and may vary from mild neurological deficits consisting of visual, oculomotor, and behavioral abnormalities to a locked-in state or coma.3,4 however, severe and persistent ABSTRACT: Objective: to identify predictors of good outcome in acute basilar artery occlusion (Bao). Background: acute ischemic stroke (aiS) caused by Bao is often associated with a severe and persistent neurological deficit and a high mortality rate. Methods: the set consisted of 70 consecutive aiS patients (51 males; mean age 64.5±14.5 years) with Bao. the role of the following factors was assessed: baseline characteristics, stroke risk factors, pre-event antithrombotic treatment, neurological deficit at time of treatment, estimated time to therapy procedure initiation, treatment method, recanalization rate, change in neurological deficit, post-treatment imaging findings. 30-and 90-day outcome was assessed using the modified rankin scale with a good outcome defined as a score of 0-3. Results: the following statistically significant differences were found between patients with good versus poor outcomes: mean age (54 RÉSUMÉ: Facteurs de prédiction du résultat dans l'occlusion aiguë de l'artère basilaire. Objectif : le but de l'étude était d'identifier les facteurs de prédiction d'une issue favorable dans l'occlusion aiguë de l'artère basilaire (oaB). Contexte : l'accident vasculaire cérébral ischémique aigu (aVCia) causé par une oaB est souvent associé à un déficit neurologique sévère et persistant et à un taux de mortalité élevé. Méthodes : l'étude a porté sur 70 patients consécutifs atteints d'une oaB, dont 51 étaient des hommes et dont l'âge moyen était de 64,5 ± 14,5 ans. nous avons étudié le rôle des facteurs suivants : les caractéristiques des patients à l'évaluation initiale, les facteurs de risque d'un aVC, le traitement antithrombotique avant l'oaB, le déficit neurologique au moment du traitement, le temps écoulé entre le début des symptômes et le début du traitement, le mode de traitement, le taux de recanalisation, les changements constatés concernant le déficit neurologique, les constatations à l'imagerie après le traitement. nous avons évalué les résultats à deux reprises, soit 30 jours et 90 jours après l'événement, au moyen de l'échelle modifiée de rankin, une issue favorable étant définie comme un score de 0 à 3. Résultats : les différences suivantes étaient significatives au point de vue statistique entre les patients dont l'issue était bonne par rapport à ceux dont l'issue était médiocre : l'âge moyen des patients (54,2 vs. 68,9 ans ; p = 0,0001), la présence d'hypertension artérielle (52,4% vs. 83,7% ; p = 0,015), de diabète (9,5% vs. 55,1% ; p = 0,0004) et d'un aVC sévère (14,3% vs. 65,3%; p = 0,0002), le déf...

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Section: Discussionsupporting

confidence: 52%

Outcome Predictors in Acute Basilar Artery Occlusion

Dorňák¹,

Herzig²,

Školoudík³

et al. 2014

Can. J. Neurol. Sci.

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“…In several studies, PTA and permanent intracranial stent placement were performed in addi-tion to thrombolysis and thrombectomy as an on-demand or rescue procedure, with higher recanalization rates than intravenous or intra-arterial thrombolysis alone, ranging from 70%-94%. 23,25,26,32 Therefore, PTA and/or permanent intracranial stent implantation at the site of the stenosis is still a treatment option when partial recanalization is achieved with a stent retriever.…”

Section: Discussionmentioning

confidence: 99%

Technical Feasibility and Application of Mechanical Thrombectomy with the Solitaire FR Revascularization Device in Acute Basilar Artery Occlusion

Mordasini

Brekenfeld

Byrne

et al. 2012

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Acute BAO is a devastating neurological condition associated with a poor clinical outcome and a high mortality rate. Recanalization has been identified as a major prognostic factor for good outcome in BAO. Mechanical thrombectomy using retrievable stents is an emerging treatment option for acute stroke. First clinical trials using stent retrievers have shown promising high recanalization rates. However, these studies mainly included large artery occlusions in the anterior circulation with only a few or single cases of BAO. Therefore, the purpose of this study was to evaluate technical feasibility, safety, and efficacy of mechanical thrombectomy using retrievable stent in the treatment of acute BAO.

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“…More investigators have recently reported that IA thrombolysis with urokinase is safe and efficacy for the treatment of stroke patients [38][39][40][41]. In addition, urokinase is more economical than rt-PA, which could significantly reduce medical costs for stroke patients and also means that more patients might benefit from thrombolysis therapy.…”

Section: Discussionmentioning

confidence: 99%

A Combined Treatment with Taurine and Intra-arterial Thrombolysis in an Embolic Model of Stroke in Rats: Increased Neuroprotective Efficacy and Extended Therapeutic Time Window

Guan

Zhao

2010

Transl. Stroke Res.

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Combination treatment may target different pathophysiological events following cerebral ischemia thus enhancing the efficacy of treatment in thromboembolic stroke. Taurine confers a neuroprotective effect in the mechanical stroke model. This effect has not been assessed in an embolic stroke model. Here, we sought to evaluate the neuroprotective effect of taurine alone and in combination with thrombolytic therapy to investigate whether combined administration would extend the therapeutic time window without increasing the hemorrhagic transformation in a rat embolic stroke model. Rats were subjected to right embolic middle cerebral artery occlusion and then randomly assigned to the following groups: saline treatment alone at 4 h, urokinase, taurine treatment alone at 4, 6, or 8 h, and the combination of taurine and urokinase at 4, 6, or 8 h after the insult. Brain infarct volume, neurobehavioral outcome, regional cerebral blood flow, intracranial hemorrhage incidence were observed and evaluated. Posttreatment with taurine at 4 or 6 h, urokinase at 4 h or in combination at 4, 6, or 8 h significantly reduced infarct volume and improved neurobehavioral outcome. The combination treatment had better neurobehavioral outcome and smaller infarction volume than urokinase or taurine treatment alone. The clinical outcome correlated well with infarct volume. Together, the present study suggests that administration of taurine after stroke is neuroprotective, seemingly because it reduces the reperfusion damage of urokinase, leading to widen the therapeutic window for the thrombolytic effect of urokinase to 8 h. Thrombolysis can also enhance the neuroprotective effect of taurine. The reduction of inflammatory response, neuron death and inhibition of blood brain barrier (BBB) disruption may underlie the beneficial effects of combination of taurine and urokinase in the treatment of embolic stroke.

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Intraarterial Thrombolysis and Stent Placement for Acute Basilar Artery Occlusion

Cited by 14 publications

References 20 publications

Outcome Predictors in Acute Basilar Artery Occlusion

Outcome Predictors in Acute Basilar Artery Occlusion

Technical Feasibility and Application of Mechanical Thrombectomy with the Solitaire FR Revascularization Device in Acute Basilar Artery Occlusion

A Combined Treatment with Taurine and Intra-arterial Thrombolysis in an Embolic Model of Stroke in Rats: Increased Neuroprotective Efficacy and Extended Therapeutic Time Window

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