Posterior communicating and vertebral artery configuration and outcome in endovascular treatment of acute basilar artery occlusion

Haussen, Diogo C; Dharmadhikari, Sushrut; Snelling, Brian; Lioutas, Vasileios‐Arsenios; Thomas, Ajith J.; Peterson, Eric C.; Elhammady, Mohamed Samy; Aziz-Sultan, Mohammad Ali; Yavagal, Dileep R.

doi:10.1136/neurintsurg-2014-011327

Cited by 12 publications

(10 citation statements)

References 19 publications

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“…26 Others have not been able to show a relationship between PCoA size and outcome in IAT treated patients with a BAO. 27 Although the BASICS registry is the largest prospective registry of consecutive patients with an acute BAO, the observational design inherently has limitations. First, with 149 patients included in the current study the sample size is still small.…”

Section: Discussionmentioning

confidence: 99%

Collateral flow predicts outcome after basilar artery occlusion: The posterior circulation collateral score

Hoeven

McVerry

Vos

et al. 2016

International Journal of Stroke

101

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Section: Discussionmentioning

confidence: 99%

Collateral flow predicts outcome after basilar artery occlusion: The posterior circulation collateral score

Hoeven

McVerry

Vos

et al. 2016

International Journal of Stroke

101

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“…Previous studies investigating the effect of PcoA in the outcome of brain stem infarcts are conflicting. One study investigating basilar artery occlusion infarcts provided no relation of PcoA hypoplasia or vertebral artery configuration with functional outcome (24). Another study, on the other hand, showed an association between PcoA hypoplasia and poor functional outcome at the end of 1st month (25).…”

Section: Discussionmentioning

confidence: 99%

The association of posterior communicating artery hypoplasia with early neurological deterioration in pontine infarcts with basilar artery stenosis

Gökçal¹,

Uslu²,

Asıl³

2019

TÃ¼rk Beyin Damar Hast Derg

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INTRODUCTION: Early neurological deterioration (END) is a common problem of stroke practice. Although lacunar pontine infarcts are known with the high risk of END, such worsening can also be seen in patients with pontine infarcts attributed to basilar artery stenosis. Since the quality of collateral supply are considered one of the proposed mechanisms of END, we hypothesized that the pattern of posterior communicating arteries (PcoA) would be associated with END in pontine infarcts with basilar artery stenosis. METHODS: Patients with acute pontine infarcts and having ≥50 basilar artery stenosis were included in the study. END was diagnosed as an increase of at least 2 points on the National Institutes of Health Stroke Scale from baseline during the 5 days. A diagnosis of PcoA hypoplasia was based on the presence of either a PcoA of less than 1 mm in diameter or the absence of a PcoA, based on computed tomography angiography (CTA). Univariate and multivariate analysis were performed to compare demographics, risk factors and the hypoplasi of PcoA between patients with END and those without END. RESULTS: Of 60 patients included, 17 patients (28.3%) exhibited END. Demographics and vascular risk factors did not differ between groups. END was significantly higher in patients having at least one hypoplastic PcoA and those with bilateral PcoA hypoplasia as compared to patients without hypoplasia (p=0.040, p=0.006, respectively). In multivariate analysis, there was a trend for the development of END in patients with bilateral hypoplastic PcoA (β =1.9, 95% CI 0.8-59; p=0.073). DISCUSSION and CONCLUSION: Bilateral hypoplasia of PcoA might be associated with the development of END in pontine infarcts attributed to basilar arteries.

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“…Anatomical variation of the vertebrobasilar system is very common, which may contribute to the associated morbidity of the VA pseudoaneurysm development and treatment [ 17 ]. Asymmetry due to a unilateral hypoplastic VA, extracranial VA occlusion, or VA ending in the posterior inferior cerebellar artery (PICA) may result in increased reliance on the contralateral VA.…”

Section: Discussionmentioning

confidence: 99%

Application of Pipeline Embolization Device for Iatrogenic Pseudoaneurysms of the Extracranial Vertebral Artery: A Case Report and Systematic Review of the Literature

Dolati¹,

Eichberg

Thomas

et al. 2015

Cureus

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Traumatic pseudoaneurysms of the vertebral artery (VA) are uncommon vascular lesions and definitive management is often challenging. Between 0% and 8% of craniocervical fusions are complicated by VA injury. In these cases, preserving the vertebral artery while treating the pseudoaneurysm is the goal of any treatment option. We describe the second known case of a patient with and iatrogenic extracranial vertebral artery pseudoaneurysm treated effectively using the Pipeline Embolization Device (PED) (Ev3 Neurovascular, Irvine, CA). Although there have been only two cases reported, the use of flow-diverting stents appears to be efficacious for the treatment of non-actively bleeding traumatic pseudoaneurysms.

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Posterior communicating and vertebral artery configuration and outcome in endovascular treatment of acute basilar artery occlusion

Abstract: Reperfusion emerged as a predictor of good outcome in patients that underwent IAT for BAO. Angioarchitectural variations of the posterior circulation were not found to impact reperfusion or clinical outcome.

Cited by 12 publications

References 19 publications

Collateral flow predicts outcome after basilar artery occlusion: The posterior circulation collateral score

Collateral flow predicts outcome after basilar artery occlusion: The posterior circulation collateral score

The association of posterior communicating artery hypoplasia with early neurological deterioration in pontine infarcts with basilar artery stenosis

Application of Pipeline Embolization Device for Iatrogenic Pseudoaneurysms of the Extracranial Vertebral Artery: A Case Report and Systematic Review of the Literature

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