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Endovascular treatment of acute intracranial vertebrobasilar artery occlusion: a multicenter retrospective observational study

  • Interventional Neuroradiology
  • Published:
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Abstract

Purpose

This study aimed to evaluate prognostic parameters associated with favorable clinical prognosis and assess the feasibility and safety of three different treatment strategies in patients with acute intracranial vertebrobasilar artery occlusion (VBAO).

Methods

A total of 159 patients with acute VBAO at 3 stroke centers between September 2015 and October 2018 were retrospectively analyzed. Eighty-nine patients underwent mechanical thrombectomy (MT) alone, 43 underwent MT with additional rescue angioplasty, and 27 underwent primary balloon angioplasty (without or with stenting). In patients treated with primary or rescue balloon angioplasty (without or with stenting), a low-dose intra-arterial tirofiban injection was used. The reperfusion status was assessed after the procedure, and the functional outcome was assessed at 90-day follow-up. The baseline characteristics and 90-day prognosis of three different treatment subgroups were comparatively analyzed.

Results

Overall, successful reperfusion and a favorable outcome were achieved in 96.86% (154/159) and 46.54% (74/159) patients, respectively. The onset to puncture time (461.96 min vs 603.59 min, P = 0.000), procedure time (64.12 min vs 70.47 min, P = 0.007), and onset to reperfusion time (526.08 min vs 674.47 min, P = 0.000) were significantly shorter in patients with favorable outcomes than in those with poor outcomes. Among different endovascular treatment subgroups, no significant differences were found in successful reperfusion and 90-day outcome. Low-dose tirofiban did not increase the risk of symptomatic intracranial hemorrhage and the 90-day mortality in patients with acute VBAO.

Conclusion

Individualized endovascular treatment strategy for selected patients with acute VBAO could achieve satisfactory reperfusion rate and favorable prognosis.

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Funding

No funding was received for this study.

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Author notes

  1. TQ and HH contributed equally to this work.

Authors and Affiliations

  1. Department of Interventional Neuroradiology, The First Affiliated Hospital of Zhengzhou University, Road Jianshe No. 1, Zhengzhou City, 450052, China

    Tao Quan, Jiachen Sun, Sheng Guan & Haowen Xu

  2. Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China

    Haiman Hou & Yuming Xu

  3. Department of Neurology, The First People’s Hospital of Pingdingshan City, Pingdingshan, China

    Wenjun Xue & Hengfei Ma

  4. Department of Neurology, The Centre Hospital of Zhumadian City, Zhumadian, China

    Guangzhou Yu

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  1. Tao Quan
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  2. Haiman Hou
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  9. Haowen Xu
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Correspondence to Haowen Xu.

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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the local institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Quan, T., Hou, H., Xue, W. et al. Endovascular treatment of acute intracranial vertebrobasilar artery occlusion: a multicenter retrospective observational study. Neuroradiology 61, 1477–1484 (2019). https://doi.org/10.1007/s00234-019-02282-1

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