Mechanical thrombectomy of severe acute basilar artery occlusion

Abstract

  Severe acute basilar artery occlusion (BAO) has a high morbidity and mortality rates. We summarized our clinical experience of mechanical thrombectomy (MT) for severe acute BAO in order to evaluate the surgical indication of MT. From 2018 to 2020, we treated consecutive 9 cases of MT for acute BAO. Of the 9 cases, 7 patients who were severe infarction with over 26 points of National Institutes of Health Stroke Scale (NIHSS) at administration were inclusion in this study. All patients were men. The mean age was 64±13.6 years (range: 43‒78 years) and had a mean NIHSS score of 32.7±4.2 (range: 27‒37). The time from onset to perfusion ranged from 123 to 713 minutes (a median of 342). The time from puncture to perfusion ranged from 29 to 76 minutes (a median of 40). A technical complication was not found. Perfusion was confirmed in all of cases. Their 90 days follow‒up outcomes showed only one case of mRS 0‒2 and 5 cases of mRS 6. Especially, 3 out of 4 patients whom were on a ventilator or were used vasopressor agent was died. Severe acute BAO is a very high fatality rate. However, the mechanical thrombectomy was occasionally effective in patients with severe acute BAO. Severe acute BAO feasible treatment needs more efforts to assure patients better clinical outcomes.