There was no predetermined protocol for the treatment of BAO with endovascular procedure at our hospital during the study period. The institutional review board approved this study (AJIRB-MED-MDB-20-084) and waived the requirement for written informed consent based on the retrospective study design.Īll patients with a clinical diagnosis of acute ischemic stroke (AIS) due to basilar artery occlusion who underwent initiation of endovascular stroke treatment with complete angiographic evaluation were included. This study was a single-center, retrospective analysis of patients who were treated with SR or MAT as a first-line method for acute BAO from March 2016 to December 2019. In this study, we aimed to compare the efficacy and safety of MAT using a large-bore catheter and that of SR in patients with BAO. However, there is a paucity of data on the role of MAT using a large-bore catheter compared with SR thrombectomy for patients with BAO. There have been several recent studies comparing the efficacy and safety of the catheter aspiration technique and the standard stent retriever technique as a fist-line endovascular treatment in patients with anterior circulation LVO.
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The main methods of MT for LVO include stent retriever (SR) thrombectomy or manual aspiration thrombectomy (MAT) with a large-bore distal access catheter. Mechanical thrombectomy (MT) techniques have evolved rapidly in an effort to improve the rate of successful recanalization for acute ischemic stroke due to large vessel occlusion (LVO). Despite advances in acute ischemic stroke treatment recently, the prognosis remains poor with a high mortality rate in patients with BAO, especially in the absence of early reperfusion.
Selection of MAT using a large-bore aspiration catheter for acute BAO may be a safe and effective first-line treatment method with higher first-pass recanalization rate and shorter procedure time than SR.Īcute basilar artery occlusion (BAO) is a rare condition, accounting for about 1% of all strokes. However, there were four cases of procedure-related subarachnoid hemorrhage (SAH) in the SR group and one death occurred due to massive hemorrhage. There was no significant difference in the incidence of any hemorrhagic complication (6.3% vs. 38.2%, p = 0.044), and lower median number of passes (1 vs 2 p = 0.008) when compared with the SR group. 65 min p = 0.001), higher rate of first-pass recanalization (68.8% vs. The MAT group had a shorter procedure time (28 vs. Sixteen (32%) patients were treated with MAT with a large-bore aspiration catheter and 34 (68%) with a SR as the first-line treatment method. The treatment and clinical outcomes were compared. Patients were assigned to one of two groups based on the first-line recanalization method.
The records of 50 patients with acute BAO who underwent mechanical thrombectomy were retrospectively reviewed. Here we compare the results of mechanical thrombectomy using a stent retriever (SR) and manual aspiration thrombectomy (MAT) using a large-bore aspiration catheter system as a first-line recanalization method in acute basilar artery occlusion (BAO). A large-bore aspiration catheter can be employed for recanalization of acute basilar artery occlusion.
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