Endovascular revascularisation of acute tandem vertebrobasilar artery occlusion: seven case series with literature reviews

Stroke Vasc Neurol. 2018 Jan 24;3(1):17-21. doi: 10.1136/svn-2017-000125. eCollection 2018 Mar.

Abstract

Background: The outcome of acute ischaemic stroke due to tandem vertebrobasilar artery occlusion was poor. Endovascular revascularisation may be a positive approach for acute basilar artery occlusion combined with vertebral ostium stenosis or occlusion. We reported seven patients with acute vertebrobasilar tandem occlusion by using angioplasty or stenting for proximal lesion and thrombectomy for distal occlusion.

Materials and methods: Consecutive patients with acute tandem vertebrobasilar artery occlusion at two centres were included in this study. We retrospectively analysed the clinical, technical and functional outcomes of the patients.

Results: From March 2016 to March 2017, seven patients were included. The mean age and National Institute of Health Stroke Scale score at admission was 57 years and 22, respectively. A reverse approach was used in five patients. The Thrombolysis in Cerebral Infarction score 2b-3 was acquired in all patients. There were no procedural complications. The modified Rankin Scale score was 1-2 for three patients and 4 for one patient at 3 months. Three patients died at 3 months of follow-up.

Conclusions: Endovascular revascularisation may be feasible for acute tandem vertebrobasilar artery occlusion, and more researches are needed.

Keywords: basilar artery; occlusion; stroke; tandem occlusion; thrombectomy.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Angioplasty, Balloon* / adverse effects
  • Angioplasty, Balloon* / instrumentation
  • Angioplasty, Balloon* / mortality
  • Disability Evaluation
  • Female
  • Functional Status
  • Humans
  • Ischemic Stroke / diagnostic imaging
  • Ischemic Stroke / mortality
  • Ischemic Stroke / physiopathology
  • Ischemic Stroke / therapy*
  • Male
  • Middle Aged
  • Recovery of Function
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Stents
  • Thrombectomy* / adverse effects
  • Thrombectomy* / mortality
  • Time Factors
  • Treatment Outcome
  • Vertebrobasilar Insufficiency / diagnostic imaging
  • Vertebrobasilar Insufficiency / mortality
  • Vertebrobasilar Insufficiency / physiopathology
  • Vertebrobasilar Insufficiency / therapy*