Mechanical thrombectomy with the Solitaire device in acute basilar artery occlusion

Abstract

Mechanical thrombectomy with the Solitaire FR device can rapidly and effectively contribute to a high rate of recanalization and improve functional outcome in patients with ABAO and has an acceptable complication rate.

Acute Basilar Artery Occlusion: Outcome of Mechanical Thrombectomy with Solitaire Stent within 8 Hours of Stroke Onset

“…Recent studies with the use of mechanical thrombectomy with stent retrievers reported significantly increased recanalization rates ranging from 74 -100% in patients with acute BAO. [12][13][14] In our study, we achieved successful recanalization (TICI grades 2b to 3) in 96% (24/25) of patients, which is in line with previous reports. Successful recanalization with only the Solitaire stent occurred in 84% (21/25) of patients.…”

“…[12][13][14] In contrast to our study, these previous studies included patients treated within 24 hours of stroke symptom onset. In a series of 14 patients treated with a Solitaire thrombectomy, Mordasini et al 12 reported that 28.6% (4/14) had a good outcome (mRS 0 -2), and the mortality rate was 35.7% (5/14).…”

“…In their study, good functional outcome (mRS 0 -2) was achieved in 50% (9/18), the mortality rate was 22.3% at 3 months, and time from symptom onset to groin puncture was 366 minutes. Most recently, in a series of 31 patients treated with Solitaire thrombectomy as the first-line endovascular treatment, Mourand et al 14 reported that 35% (11/31) had a good outcome, the mortality rate was 32% (10/31), and mean time from symptom onset to recanalization was 512 minutes. This group did not provide data regarding the time to treatment.…”

“…They reported a symptomatic hemorrhage rate of 0%, similar to that in our study. In a series of 31 patients with BAO treated with a Solitaire thrombectomy, Mourand et al 14 reported that vertebral artery dissection occurred in 1 patient, and no vessel perforation was observed. They also reported that symptomatic hemorrhage occurred in 16% (5/31) of patients, which is quite frequent compared with other reports.…”

“…The efficacy of stent retrievers for treating acute BAO was reported in several recent case series. [12][13][14] These previous studies used a longer time window of up to 24 hours for mechanical thrombectomy in patients with acute BAO. However, BASICS showed that early recanalization therapy in patients with acute BAO is associated with a more favorable outcome, and all patients with severe stroke treated Ͼ9 hours after symptom onset had poor functional outcome despite IV or IA thrombolysis.…”