The use of mechanical thrombectomy in the treatment of basilar artery occlusion – case report

Abstract

Occlusion of the basilar artery (BAO) is a rare cause of stroke, making up approximately 1% of all cases. Ischemic stroke within the basilar artery is associated with serious complications and high mortality (75-91%). BAO may occur initially in the form of mild prodromal symptoms with neurological disorders, the consequences of which can lead to death. For these reasons, BAO requires rapid diagnosis and treatment. We report the case of a 26-year-old man who suffered basilar artery occlusion and was treated with endovascular therapy. The patient was disqualified from intra-venous thrombolysis and endovascular treatment due to exceeding the therapeutic time window. Despite this, due to the location of ischemia and age of the patient, it was decided to proceed with a mechanical thrombectomy (TM). Vessel patency was restored using the Solitaire FR stent. Treatment continued with antiplatelet therapy. Despite a significant overshoot of the time window the procedure was successful and complete recanalization was achieved. During hospitalization, significant neurological symptom reductions were observed. There is no accurate data on which method of treatment of ischemic stroke is best for BAO. Expectations about the effectiveness of endovascular techniques are high.

Morphological characteristics of lateral branches of human basilar artery

“…Knowledge of the morphological characteristics of the BA, its lateral branches and side branches is important in understanding the ischemic lesions of the cerebellum, pons and medulla oblongata. The incidence of ischemic diseases of the brain, caused by the occlusion of the arteries of the posterior segment of Willis hexagon, is 15-20% of cases and ischemia caused by the BA occlusion is reported in 1-4% of cases in respect of all ischemic brain lesions 9,17 . Distally from the place of occlusion, the BA can be filled through the vertebral arteries 18 .…”