Department of Radiology, Ajou University School of Medicine, Ajou University Medical Center, Suwon, South Korea.
BMC Neurol. 2020 Nov 30;20(1):434. doi: 10.1186/s12883-020-02013-7.
A large-bore aspiration catheter can be employed for recanalization of acute basilar artery occlusion. Here we compare the results of mechanical thrombectomy using a stent retriever (SR) and manual aspiration thrombectomy (MAT) using a large-bore aspiration catheter system as a first-line recanalization method in acute basilar artery occlusion (BAO).
The records of 50 patients with acute BAO who underwent mechanical thrombectomy were retrospectively reviewed. Patients were assigned to one of two groups based on the first-line recanalization method. The treatment and clinical outcomes were compared.
Sixteen (32%) patients were treated with MAT with a large-bore aspiration catheter and 34 (68%) with a SR as the first-line treatment method. The MAT group had a shorter procedure time (28 vs. 65 min; p = 0.001), higher rate of first-pass recanalization (68.8% vs. 38.2%, p = 0.044), and lower median number of passes (1 vs 2; p = 0.008) when compared with the SR group. There was no significant difference in the incidence of any hemorrhagic complication (6.3% vs. 8.8%; p = 0.754) between the groups. However, there were four cases of procedure-related subarachnoid hemorrhage (SAH) in the SR group and one death occurred due to massive hemorrhage.
Selection of MAT using a large-bore aspiration catheter for acute BAO may be a safe and effective first-line treatment method with higher first-pass recanalization rate and shorter procedure time than SR.
大口径抽吸导管可用于急性基底动脉闭塞再通。在此，我们比较了支架取栓术（SR）和手动抽吸血栓切除术（MAT）在急性基底动脉闭塞（BAO）作为一线再通方法中的效果，其中 MAT 采用大口径抽吸导管系统。
回顾性分析了 50 例接受机械血栓切除术的急性 BAO 患者的记录。根据一线再通方法将患者分为两组。比较治疗和临床结局。
16 例（32%）患者采用大口径抽吸导管进行 MAT 治疗，34 例（68%）患者采用 SR 作为一线治疗方法。MAT 组的手术时间更短（28 分钟 vs. 65 分钟；p=0.001），首次通过再通率更高（68.8% vs. 38.2%，p=0.044），通过次数中位数更低（1 次 vs. 2 次；p=0.008），与 SR 组相比。两组的任何出血性并发症发生率（6.3% vs. 8.8%；p=0.754）均无显著差异。然而，SR 组有 4 例与手术相关的蛛网膜下腔出血（SAH），1 例因大量出血而死亡。
对于急性 BAO，选择大口径抽吸导管进行 MAT 可能是一种安全有效的一线治疗方法，其首次通过再通率更高，手术时间更短。
