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Implications of Mechanical Endovascular Thrombectomy for Acute Basilar and Posterior Cerebral Artery Occlusion
OBJECTIVE: Protocols for posterior circulation ischemic stroke have not been established by randomized clinical trials. Mechanical endovascular thrombectomy (MET) devices are evolving, and many of these devices already developed or in development are suitable for posterior circulation MET. MATERIALS...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Society of Cerebrovascular Surgeons; Society of Korean Endovascular Neurosurgeons
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6199399/ https://www.ncbi.nlm.nih.gov/pubmed/30397588 http://dx.doi.org/10.7461/jcen.2018.20.3.168 |
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author | Lee, Hyun-Nyung Kim, Bum-Tea Im, Soo-Bin Hwang, Sun-Chul Jeong, Je-Hoon Chung, Moon-Young Park, Jong-Hyun Shin, Dong-Seong |
author_facet | Lee, Hyun-Nyung Kim, Bum-Tea Im, Soo-Bin Hwang, Sun-Chul Jeong, Je-Hoon Chung, Moon-Young Park, Jong-Hyun Shin, Dong-Seong |
author_sort | Lee, Hyun-Nyung |
collection | PubMed |
description | OBJECTIVE: Protocols for posterior circulation ischemic stroke have not been established by randomized clinical trials. Mechanical endovascular thrombectomy (MET) devices are evolving, and many of these devices already developed or in development are suitable for posterior circulation MET. MATERIALS AND METHODS: We investigated the medical records of patients who underwent MET for posterior circulation ischemic stroke from January 2012 to August 2016. Fifteen patients were included. MET was performed in patients with or without injected intravenous tissue plasminogen activator. MET was considered in patients with a National Institute of Health Stroke Scale score of 4 or more, older than 18 years, with definite occlusion of the basilar artery or posterior cerebral artery (PCA), and who arrived at the hospital within 24 hours from onset. RESULTS: The direct catheter aspiration technique was used in five cases, and the stent retrieval technique was used in seven cases. The stent retrieval technique with the direct aspiration technique was used in three cases. Recanalization failed in two cases. Basilar occlusion without PCA involvement is the only effective factor of successful recanalization (p = 0.03). Successful recanalization (p = 0.005) and the presence of a posterior communicating artery (p = 0.005) affected the good outcome at discharge. CONCLUSION: An early diagnosis and active MET may improve the patient outcome. MET may help recanalization and good flow restoration and the potential for a good outcome. |
format | Online Article Text |
id | pubmed-6199399 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Korean Society of Cerebrovascular Surgeons; Society of Korean Endovascular Neurosurgeons |
record_format | MEDLINE/PubMed |
spelling | pubmed-61993992018-11-05 Implications of Mechanical Endovascular Thrombectomy for Acute Basilar and Posterior Cerebral Artery Occlusion Lee, Hyun-Nyung Kim, Bum-Tea Im, Soo-Bin Hwang, Sun-Chul Jeong, Je-Hoon Chung, Moon-Young Park, Jong-Hyun Shin, Dong-Seong J Cerebrovasc Endovasc Neurosurg Original Article OBJECTIVE: Protocols for posterior circulation ischemic stroke have not been established by randomized clinical trials. Mechanical endovascular thrombectomy (MET) devices are evolving, and many of these devices already developed or in development are suitable for posterior circulation MET. MATERIALS AND METHODS: We investigated the medical records of patients who underwent MET for posterior circulation ischemic stroke from January 2012 to August 2016. Fifteen patients were included. MET was performed in patients with or without injected intravenous tissue plasminogen activator. MET was considered in patients with a National Institute of Health Stroke Scale score of 4 or more, older than 18 years, with definite occlusion of the basilar artery or posterior cerebral artery (PCA), and who arrived at the hospital within 24 hours from onset. RESULTS: The direct catheter aspiration technique was used in five cases, and the stent retrieval technique was used in seven cases. The stent retrieval technique with the direct aspiration technique was used in three cases. Recanalization failed in two cases. Basilar occlusion without PCA involvement is the only effective factor of successful recanalization (p = 0.03). Successful recanalization (p = 0.005) and the presence of a posterior communicating artery (p = 0.005) affected the good outcome at discharge. CONCLUSION: An early diagnosis and active MET may improve the patient outcome. MET may help recanalization and good flow restoration and the potential for a good outcome. Korean Society of Cerebrovascular Surgeons; Society of Korean Endovascular Neurosurgeons 2018-09 2018-09-30 /pmc/articles/PMC6199399/ /pubmed/30397588 http://dx.doi.org/10.7461/jcen.2018.20.3.168 Text en © 2018 Journal of Cerebrovascular and Endovascular Neurosurgery http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Lee, Hyun-Nyung Kim, Bum-Tea Im, Soo-Bin Hwang, Sun-Chul Jeong, Je-Hoon Chung, Moon-Young Park, Jong-Hyun Shin, Dong-Seong Implications of Mechanical Endovascular Thrombectomy for Acute Basilar and Posterior Cerebral Artery Occlusion |
title | Implications of Mechanical Endovascular Thrombectomy for Acute Basilar and Posterior Cerebral Artery Occlusion |
title_full | Implications of Mechanical Endovascular Thrombectomy for Acute Basilar and Posterior Cerebral Artery Occlusion |
title_fullStr | Implications of Mechanical Endovascular Thrombectomy for Acute Basilar and Posterior Cerebral Artery Occlusion |
title_full_unstemmed | Implications of Mechanical Endovascular Thrombectomy for Acute Basilar and Posterior Cerebral Artery Occlusion |
title_short | Implications of Mechanical Endovascular Thrombectomy for Acute Basilar and Posterior Cerebral Artery Occlusion |
title_sort | implications of mechanical endovascular thrombectomy for acute basilar and posterior cerebral artery occlusion |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6199399/ https://www.ncbi.nlm.nih.gov/pubmed/30397588 http://dx.doi.org/10.7461/jcen.2018.20.3.168 |
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