Outcome and recanalization rate of tandem basilar artery occlusion treated by mechanical thrombectomy.

Aged Angiography, Digital Subtraction Basilar Artery Cerebral Angiography Female Humans Male Middle Aged Retrospective Studies Thrombectomy / methods Vertebral Artery Vertebrobasilar Insufficiency / diagnostic imaging
Basilar artery occlusion Mechanical thrombectomy Outcome Recanalization Tandem Vertebral artery occlusion

Journal

Journal of neuroradiology = Journal de neuroradiologie
ISSN: 0150-9861
Titre abrégé: J Neuroradiol
Pays: France
ID NLM: 7705086

Informations de publication

Date de publication:
Nov 2020
Historique:
received: 23 08 2020
revised: 26 08 2020
accepted: 26 08 2020
pubmed: 11 9 2020
medline: 6 7 2021
entrez: 10 9 2020
Statut: ppublish

Résumé

Tandem basilar artery occlusions (tBAO) are defined as concomitant basilar artery and extracranial dominant vertebral artery occlusions. The prognosis of such tBAO treated by mechanical thrombectomy (MT) has been scantly reported. The purpose of our study was to compare the safety and effectiveness of MT for patients with tBAO compared to those with non-tandem basilar artery occlusions (ntBAO). Retrospective analysis of a database of patients who underwent MT at two academic centres. All patients treated for BAO were retrieved. Patients with tBAO, defined as a concomitant BAO and extracranial vertebral artery (VA) occlusion or severe stenosis ≥70% (V1 or proximal V2 segment) were compared with patients with ntBAO. A total of 15 patients with tBAO and 74 patients with ntBAO were enrolled. Successful reperfusion (modified thrombolysis in cerebral infarction score ≥2b) was obtained in 73.3% versus 90.5% (OR = 0.29, 95%CI: 0.07-1.15), good clinical outcome (3-months modified Rankin scale ≤2) was reached by 26.7% versus 32.4% (OR = 0.76; 95% CI: 0.24-2.63) and mortality at 3-months was 46.7% versus 31% (OR = 1.94; 95%CI: 0.63-6) of patients with tBAO versus ntBAO, respectively. Two patients (13.3%) with tBAO and three (4%) with ntBAO had symptomatic intracranial haemorrhage (OR = 3.64; 95% CI: 0.55-24). Mechanical thrombectomy for patients with tandem basilar artery occlusion tends to be associated with lower rates of successful reperfusion and good clinical outcome, and higher rate of mortality. Larger multicentre studies are warranted to better precise the proper selection and management of such patients.

Sections du résumé

BACKGROUND BACKGROUND
Tandem basilar artery occlusions (tBAO) are defined as concomitant basilar artery and extracranial dominant vertebral artery occlusions. The prognosis of such tBAO treated by mechanical thrombectomy (MT) has been scantly reported. The purpose of our study was to compare the safety and effectiveness of MT for patients with tBAO compared to those with non-tandem basilar artery occlusions (ntBAO).
PATIENTS AND METHODS METHODS
Retrospective analysis of a database of patients who underwent MT at two academic centres. All patients treated for BAO were retrieved. Patients with tBAO, defined as a concomitant BAO and extracranial vertebral artery (VA) occlusion or severe stenosis ≥70% (V1 or proximal V2 segment) were compared with patients with ntBAO.
RESULTS RESULTS
A total of 15 patients with tBAO and 74 patients with ntBAO were enrolled. Successful reperfusion (modified thrombolysis in cerebral infarction score ≥2b) was obtained in 73.3% versus 90.5% (OR = 0.29, 95%CI: 0.07-1.15), good clinical outcome (3-months modified Rankin scale ≤2) was reached by 26.7% versus 32.4% (OR = 0.76; 95% CI: 0.24-2.63) and mortality at 3-months was 46.7% versus 31% (OR = 1.94; 95%CI: 0.63-6) of patients with tBAO versus ntBAO, respectively. Two patients (13.3%) with tBAO and three (4%) with ntBAO had symptomatic intracranial haemorrhage (OR = 3.64; 95% CI: 0.55-24).
CONCLUSION CONCLUSIONS
Mechanical thrombectomy for patients with tandem basilar artery occlusion tends to be associated with lower rates of successful reperfusion and good clinical outcome, and higher rate of mortality. Larger multicentre studies are warranted to better precise the proper selection and management of such patients.

Identifiants

DOI: 10.1016/j.neurad.2020.08.004 PMID: 32910987
pubmed: 32910987
pii: S0150-9861(20)30246-7
doi: 10.1016/j.neurad.2020.08.004
pii:
doi:

Types de publication

Comparative Study Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

404-409

Informations de copyright

Copyright © 2020 Elsevier Masson SAS. All rights reserved.

Auteurs

Mahmoud Elhorany (M)

Sorbonne University, Paris VI University, Paris, France; GRC-14 Biosfast, Paris VI University, Paris, France; Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France; Department of Neurology, Faculty of Medicine, Tanta University, Egypt.

Grégoire Boulouis (G)

INSERM-U1266, Interventional Neuroradiology Department, Sainte-Anne Hospital, Paris V University, Paris, France.

Wagih Ben Hassen (WB)

INSERM-U1266, Interventional Neuroradiology Department, Sainte-Anne Hospital, Paris V University, Paris, France.

Sophie Crozier (S)

Department of Vascular Neurology, Pitié-Salpêtrière Hospital, Paris, France.

Eimad Shotar (E)

Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France.

Nader-Antoine Sourour (NA)

Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France.

Stephanie Lenck (S)

Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France.

Kevin Premat (K)

Sorbonne University, Paris VI University, Paris, France; Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France.

Robert Fahed (R)

Department of Interventional Neuroradiology, Fondation A. de Rothschild, Paris, France.

Vincent Degos (V)

Sorbonne University, Paris VI University, Paris, France; GRC-14 Biosfast, Paris VI University, Paris, France; Department of Anaesthesiology, Pitié-Salpêtrière Hospital, Paris, France.

Ahmed Mohamed Elhfnawy (AM)

Sorbonne University, Paris VI University, Paris, France; GRC-14 Biosfast, Paris VI University, Paris, France; Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France; Department of Neurology, Faculty of Medicine, Alexandria University, Egypt.

Ossama Yassin Mansour (OY)

Department of Neurology, Faculty of Medicine, Alexandria University, Egypt.

El-Sayed Ali Tag El-Din (EA)

Department of Neurology, Faculty of Medicine, Tanta University, Egypt.

Wael Ahmed Fadel (WA)

Department of Neurology, Faculty of Medicine, Tanta University, Egypt.

Sonia Alamowitch (S)

Sorbonne University, Paris VI University, Paris, France; Department of Vascular Neurology, Saint-Antoine University Hospital, Paris, France.

Yves Samson (Y)

Sorbonne University, Paris VI University, Paris, France; Department of Vascular Neurology, Pitié-Salpêtrière Hospital, Paris, France.

Olivier Naggara (O)

INSERM-U1266, Interventional Neuroradiology Department, Sainte-Anne Hospital, Paris V University, Paris, France.

Frédéric Clarençon (F)

Sorbonne University, Paris VI University, Paris, France; GRC-14 Biosfast, Paris VI University, Paris, France; Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France. Electronic address: frederic.clarencon@aphp.fr.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Outcome and recanalization rate of tandem...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Techniques de diagnostic cardiovasculaire › Angiographie › Angiographie de soustraction digitale › Outcome and recanalization rate of tandem...
questionsmedicales.fr › Système cardiovasculaire › Vaisseaux sanguins › Artères › Artère basilaire › Outcome and recanalization rate of tandem...
questionsmedicales.fr › Techniques d'investigation › Neuroimagerie › Neuroradiographie › Angiographie cérébrale › Outcome and recanalization rate of tandem...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Outcome and recanalization rate of tandem...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Outcome and recanalization rate of tandem...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Outcome and recanalization rate of tandem...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie cardiovasculaire › Procédures de chirurgie vasculaire › Thrombectomie › Outcome and recanalization rate of tandem...
questionsmedicales.fr › Système cardiovasculaire › Vaisseaux sanguins › Artères › Artère vertébrale › Outcome and recanalization rate of tandem...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Encéphalopathie ischémique › Insuffisance vertébrobasilaire › Outcome and recanalization rate of tandem...