Styczen, Hanna ORCID: 0000-0002-9623-4156, Fischer, Sebastian, Yeo, Leonard L. L., Yong-Qiang Tan, Benjamin, Maurer, Christoph J., Berlis, Ansgar, Abdullayev, Nuran, Kabbasch, Christoph, Kastrup, Andreas, Papanagiotou, Panagiotis, Clajus, Christin, Lobsien, Donald, Piechowiak, Eike, Kaesmacher, Johannes and Maus, Volker . Approaching the Boundaries of Endovascular Treatment in Acute Ischemic Stroke Multicenter Experience with Mechanical Thrombectomy in Vertebrobasilar Artery Branch Occlusions. Clin. Neuroradiol.. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1869-1447

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Abstract

Purpose Little is known about catheter-based endovascular treatment of vertebrobasilar artery branch occlusion (VEBABO) in acute ischemic stroke (AIS). Nonetheless, the experience of mechanical thrombectomy (MT) in distal small sized arteries of the anterior circulation seems promising in AIS. In this multicenter study, we report the feasibility, efficacy and safety of MT in VEBABO. Methods Retrospective analysis of consecutive AIS patients treated with MT due to VEBABO including posterior and anterior inferior cerebellar artery (PICA, AICA) and superior cerebellar artery (SCA) occlusions at seven tertiary care centers between January 2013 and May 2020. Baseline demographics and angiographic outcomes including recanalization success of the affected cerebellar arteries and procedural complications were recorded. Clinical outcomes were evaluated by the modified Rankin scale (mRS) at discharge and 90 days. Results Out of 668 endovascularly treated posterior circulation strokes we identified 16 (0.02%) cases with MT for VEBABO. Most frequently, MT of the SCA was done (13/16, 81%). Most VEBABOs occurred after MT of initial basilar/posterior cerebral artery occlusion (9/16, 56%). In 10/16 (63%) procedures, the affected VEBABO was successfully recanalized. Out of four patients three (75%) with isolated VEBABO had benefited from endovascular therapy. Subarachnoid hemorrhage was observed in 3/16 (19%) procedures. The rate of favorable outcome (mRS <= 2) was 40% at discharge and 47% at 90-day follow-up. Mortality was 13% (2/15). Conclusion The use of MT for VEBABO is rare but appears to be feasible and effective; however, the comparatively high rate of procedure-related hemorrhage highlights that the indications for MT in these occlusion sites should be carefully weighed up.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Styczen, HannaUNSPECIFIEDorcid.org/0000-0002-9623-4156UNSPECIFIED
Fischer, SebastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Yeo, Leonard L. L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Yong-Qiang Tan, BenjaminUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maurer, Christoph J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berlis, AnsgarUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Abdullayev, NuranUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kabbasch, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kastrup, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Papanagiotou, PanagiotisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Clajus, ChristinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lobsien, DonaldUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Piechowiak, EikeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kaesmacher, JohannesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maus, VolkerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-314283
DOI: 10.1007/s00062-020-00970-7
Journal or Publication Title: Clin. Neuroradiol.
Publisher: SPRINGER HEIDELBERG
Place of Publication: HEIDELBERG
ISSN: 1869-1447
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
RECANALIZATION; GUIDELINES; MANAGEMENTMultiple languages
Clinical Neurology; Radiology, Nuclear Medicine & Medical ImagingMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/31428

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