Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
J Neurointerv Surg. 2010 Jun;2(2):110-4. doi: 10.1136/jnis.2009.001420.
Basilar artery occlusion remains one of the most devastating subtypes of stroke. Intravenous and intra-arterial therapy have altered the natural history of this disease; however, clinical results remain poor. Therefore, exploring more aggressive and innovative management is warranted.
Six consecutive patients presenting with a basilar artery occlusion were treated with the same general algorithm of intra-arterial tissue plasminogen activator and mechanical thrombectomy with the Merci retrieval system. If complete recanalization was not achieved after two passes, manual syringe aspiration through a 4.3F catheter was employed.
All interventions utilizing aspiration thrombectomy resulted in recanalization, with five out of six cases displaying TIMI3/TICI3 flow and one patient resulting in complete recanalization of the basilar artery with persistent thrombus in one P2 segment (TIMI2/TICI2B). All patients survived, with five out of six independent in activities of daily living at 3 months (mRS 0-2).
Our small case series indicates that aspiration thrombectomy performed manually through a 4.3F catheter can facilitate recanalization of basilar artery occlusion with acceptable clinical outcomes.
基底动脉闭塞仍然是最具破坏性的中风亚型之一。静脉内和动脉内治疗改变了这种疾病的自然病程；然而，临床结果仍然不佳。因此，有必要探索更积极和创新的治疗方法。
6 例连续基底动脉闭塞患者采用相同的动脉内组织型纤溶酶原激活物和机械血栓切除术联合 Merci 回收系统的一般算法进行治疗。如果两次通过后仍未达到完全再通，则采用手动注射器抽吸 4.3F 导管。
所有使用抽吸血栓切除术的介入治疗均实现了再通，6 例中有 5 例显示 TIMI3/TICI3 血流，1 例基底动脉完全再通，但在 P2 段仍有血栓残留（TIMI2/TICI2B）。所有患者均存活，6 例中有 5 例在 3 个月时独立进行日常生活活动（mRS 0-2）。
我们的小病例系列表明，手动通过 4.3F 导管进行抽吸血栓切除术可以促进基底动脉闭塞再通，并获得可接受的临床结果。
