Effect of Intracranial Atherosclerotic Disease on Endovascular Treatment for Patients with Acute Vertebrobasilar Occlusion
Open Access
- 16 June 2016
- journal article
- Published by American Society of Neuroradiology (ASNR) in American Journal of Neuroradiology
- Vol. 37 (11), 2072-2078
- https://doi.org/10.3174/ajnr.a4844
Abstract
BACKGROUND AND PURPOSE: Although intracranial atherosclerotic disease is often encountered during endovascular treatment for acute vertebrobasilar occlusions, its clinical implication is not well-known. We aimed to evaluate whether intracranial atherosclerotic disease influences the clinical outcomes following endovascular treatment of acute vertebrobasilar occlusive stroke. MATERIALS AND METHODS: Fifty-one patients with acute vertebrobasilar occlusive stroke were included. The onset-to-groin puncture time was ≤12 hours, and aspiration- or stent-based thrombectomy was used as the primary treatment method. Following primary endovascular treatment, intracranial atherosclerotic disease (IAD group) was angiographically diagnosed when a fixed focal stenosis was observed at the occlusion site, whereas embolism (embolic group) was diagnosed if no stenosis was observed. Clinical and treatment variables were compared in both groups, and IAD was evaluated as a prognostic factor for clinical outcomes. RESULTS: The baseline NIHSS score tended to be lower (14 versus 22, P = .097) in the IAD group (n = 19) than in the embolic group (n = 32). The procedural time was longer in the IAD group (96 versus 61 minutes, P = .002), despite similar rates of TICI 2b–3 (89.5% versus 87.5%, P = 1.000). The NIHSS score at 7 days was higher (21 versus 8, P = .060) and poor outcomes (mRS 4–6 at 3 months) were more frequent in the IAD group (73.7% versus 43.8%, P = .038). IAD (odds ratio, 5.469; 95% CI, 1.09–27.58; P = .040) was independently associated with poor outcomes. CONCLUSIONS: An arterial occlusion related to IAD was associated with a longer procedural time and poorer clinical outcome. Further studies are warranted to elucidate the appropriate endovascular strategy.Keywords
This publication has 33 references indexed in Scilit:
- Stent-Retriever Thrombectomy after Intravenous t-PA vs. t-PA Alone in StrokeThe New England Journal of Medicine, 2015
- Thrombectomy within 8 Hours after Symptom Onset in Ischemic StrokeThe New England Journal of Medicine, 2015
- Randomized Assessment of Rapid Endovascular Treatment of Ischemic StrokeThe New England Journal of Medicine, 2015
- Endovascular Therapy for Ischemic Stroke with Perfusion-Imaging SelectionThe New England Journal of Medicine, 2015
- A Randomized Trial of Intraarterial Treatment for Acute Ischemic StrokeThe New England Journal of Medicine, 2015
- Mechanical recanalization in basilar artery occlusion: The ENDOSTROKE studyAnnals of Neurology, 2014
- Forced Arterial Suction Thrombectomy with the Penumbra Reperfusion Catheter in Acute Basilar Artery Occlusion: A Retrospective Comparison Study in 2 Korean University HospitalsAmerican Journal of Neuroradiology, 2014
- Solitaire flow restoration device versus the Merci Retriever in patients with acute ischaemic stroke (SWIFT): a randomised, parallel-group, non-inferiority trialThe Lancet, 2012
- Trevo versus Merci retrievers for thrombectomy revascularisation of large vessel occlusions in acute ischaemic stroke (TREVO 2): a randomised trialThe Lancet, 2012
- Intra-Arterial Thrombolytic Therapy for Acute Basilar OcclusionStroke, 2007