2016 年 10 巻 5 号 p. 249-253
Purpose: Recent studies demonstrated the efficacy of acute-phase thrombectomy for acute major artery occlusion in anterior circulation. However, its efficacy in posterior circulation has not been verified. We examined acute-phase thrombectomy involving posterior circulation in our hospital.
Methods: The subjects were 15 patients who underwent acute-phase thrombectomy involving posterior circulation in our hospital between July 2010 and July 2015. The mean age was 74.6 years. The mean baseline National Institute of Health Stroke Scale (NIHSS) score was 24.6 points. For preoperative evaluation, MRI was performed in 13 patients, and perfusion CT in 1. The type of cerebral infarction was evaluated as cardiac embolism in nine patients (60%), atherothrombotic infarction in two (13%), and others in four (27%). A Merci, Penumbra, or stent retriever was used as a first-choice device. Nine patients were treated with several devices.
Results: In all patients, a Thrombolysis in Cerebral Infarction (TICI) score of 2B or higher was achieved. Eight patients (53%) showed a TICI score of 3. An improvement of the NIHSS score after 24 hours was achieved in 13 patients (87%), but three patients (20%) showed an mRS score of 0–2 on discharge. The mortality rate was 0% (n = 0). There was a correlation between a high signal intensity of the brain stem on MRI Diffusion Weighted Image (DWI) and the outcome.
Conclusion: Acute-phase thrombectomy was useful for relieving symptoms and reducing the mortality rate. Furthermore, the outcome was correlated with a high signal intensity of the brain stem on DWI.