Endovascular treatment combined with vertebral artery endarterectomy for patients with acute tandem vertebrobasilar artery occlusion

Abstract

Purpose: To evaluate the safety and efficacy of endovascular treatment combined with vertebral artery endarterectomy in patients with acute tandem vertebrobasilar artery occlusion.

Methods: From April 2017 to March 2019, three patients with acute basilar artery occlusion combined with ostial vertebral occlusion in our institution were enrolled in the study. They underwent endovascular treatment combined with vertebral artery endarterectomy. The clinical, technical and functional outcomes of the patients were retrospectively analysed.

Results: All three patients in the study underwent complete recanalization. The modified Thrombolysis in Cerebral Infarction (mTICI) grade was 2b/3 in all patients. The modified Rankin Scale (mRS) score was 0-2 for the three patients at 3 months. Follow-up CT scans revealed no cerebral haemorrhage, and no patients died during follow-up. All patients achieved good clinical outcomes after the combined treatment.

Conclusion: Endovascular treatment combined with vertebral artery endarterectomy is a feasible method to treat patients with acute basilar artery occlusion combined with ostial vertebral occlusion, especially when the guidewire cannot pass through the ostium of the dominant vertebral artery occlusion.

Keywords: Basilar artery occlusion; Endovascular treatment; Tandem; Vertebral artery endarterectomy; Vertebral artery occlusion.