The use of mechanical thrombectomy in the treatment of basilar artery occlusion--case report

Neurol Neurochir Pol. 2015;49(5):332-8. doi: 10.1016/j.pjnns.2015.07.004. Epub 2015 Jul 29.

Abstract

Occlusion of the basilar artery (BAO) is a rare cause of stroke, making up approximately 1% of all cases. Ischemic stroke within the basilar artery is associated with serious complications and high mortality (75-91%). BAO may occur initially in the form of mild prodromal symptoms with neurological disorders, the consequences of which can lead to death. For these reasons, BAO requires rapid diagnosis and treatment. We report the case of a 26-year-old man who suffered basilar artery occlusion and was treated with endovascular therapy. The patient was disqualified from intra-venous thrombolysis and endovascular treatment due to exceeding the therapeutic time window. Despite this, due to the location of ischemia and age of the patient, it was decided to proceed with a mechanical thrombectomy (TM). Vessel patency was restored using the Solitaire FR stent. Treatment continued with antiplatelet therapy. Despite a significant overshoot of the time window the procedure was successful and complete recanalization was achieved. During hospitalization, significant neurological symptom reductions were observed. There is no accurate data on which method of treatment of ischemic stroke is best for BAO. Expectations about the effectiveness of endovascular techniques are high.

Keywords: Embolectomy; Interventional radiology; Stroke; Thrombectomy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aerospace Medicine
  • Combined Modality Therapy
  • Contraindications
  • Cranial Nerve Diseases / etiology
  • Disease Susceptibility
  • Dysarthria / etiology
  • Epilepsy / complications
  • Humans
  • Hyperlipoproteinemia Type II / complications
  • Hypertension / complications
  • Magnetic Resonance Angiography
  • Male
  • Mechanical Thrombolysis*
  • Neuroimaging
  • Platelet Aggregation Inhibitors / therapeutic use
  • Quadriplegia / etiology
  • Stents
  • Tomography, X-Ray Computed
  • Vertebrobasilar Insufficiency / diagnostic imaging
  • Vertebrobasilar Insufficiency / drug therapy
  • Vertebrobasilar Insufficiency / etiology
  • Vertebrobasilar Insufficiency / pathology
  • Vertebrobasilar Insufficiency / surgery*
  • Young Adult

Substances

  • Platelet Aggregation Inhibitors