Endovascular treatment of acute basilar artery occlusion: Tama-REgistry of Acute Thrombectomy (TREAT) study

The effectiveness of mechanical thrombectomy (MT) for acute basilar artery occlusion (ABAO) remains unknown. We evaluated the feasibility, safety, and efficacy of endovascular treatment for ABAO. We retrospectively investigated patients with ABAO who underwent MT, using modern stent retrievers and a...

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Published in	Journal of the neurological sciences Vol. 401; pp. 29 - 33
Main Authors	Kaneko, Junya, Ota, Takahiro, Tagami, Takashi, Unemoto, Kyoko, Shigeta, Keigo, Amano, Tatsuo, Ueda, Masayuki, Matsumaru, Yuji, Shiokawa, Yoshiaki, Hirano, Teruyuki
Format	Journal Article
Language	English
Published	Netherlands Elsevier B.V 15.06.2019
Subjects	Acute basilar artery occlusion Aspiration Mechanical thrombectomy Stent retriever Successful recanalization RCT BSS LVO Aspiration IVT rtPA Acute basilar artery occlusion MT Successful recanalization OTR pc-ASPECTS ICH mTICI ABAO CTA Mechanical thrombectomy DWI Stent retriever TREAT IAT MRA BASICS
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Abstract	The effectiveness of mechanical thrombectomy (MT) for acute basilar artery occlusion (ABAO) remains unknown. We evaluated the feasibility, safety, and efficacy of endovascular treatment for ABAO. We retrospectively investigated patients with ABAO who underwent MT, using modern stent retrievers and an aspiration device, between January 2015 and December 2017 at 12 comprehensive stroke centers. Functional outcomes and 90-day mortality were analyzed as primary outcomes. Forty-eight patients were included. Good outcome (modified Rankin Scale mRS 0–2) was achieved in 20/48 patients and the all-cause 90-day mortality rate was 25%. Successful recanalization (modified Thrombolysis In Cerebral Infarction [mTICI] grade 2b and 3) was achieved in 47/48 patients. National Institutes of Health Stroke Scale, posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS), DWI Brain Stem Score, mTICI (3 > 2b), and intracranial hemorrhage were significantly different between good and poor functional outcome groups. The occlusion site of BA was significantly different between patients with moderate outcome (mRS 0–3) versus others. We found that age, pc-ASPECTS and mTICI were significantly associated with functional outcomes in the logistic regression model. MT with stent retrievers and an aspiration device for ABAO results in high successful recanalization and good outcomes. Further studies are required to confirm our results.
AbstractList	The effectiveness of mechanical thrombectomy (MT) for acute basilar artery occlusion (ABAO) remains unknown. We evaluated the feasibility, safety, and efficacy of endovascular treatment for ABAO. We retrospectively investigated patients with ABAO who underwent MT, using modern stent retrievers and an aspiration device, between January 2015 and December 2017 at 12 comprehensive stroke centers. Functional outcomes and 90-day mortality were analyzed as primary outcomes. Forty-eight patients were included. Good outcome (modified Rankin Scale mRS 0–2) was achieved in 20/48 patients and the all-cause 90-day mortality rate was 25%. Successful recanalization (modified Thrombolysis In Cerebral Infarction [mTICI] grade 2b and 3) was achieved in 47/48 patients. National Institutes of Health Stroke Scale, posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS), DWI Brain Stem Score, mTICI (3 > 2b), and intracranial hemorrhage were significantly different between good and poor functional outcome groups. The occlusion site of BA was significantly different between patients with moderate outcome (mRS 0–3) versus others. We found that age, pc-ASPECTS and mTICI were significantly associated with functional outcomes in the logistic regression model. MT with stent retrievers and an aspiration device for ABAO results in high successful recanalization and good outcomes. Further studies are required to confirm our results. OBJECTIVEThe effectiveness of mechanical thrombectomy (MT) for acute basilar artery occlusion (ABAO) remains unknown. We evaluated the feasibility, safety, and efficacy of endovascular treatment for ABAO. METHODSWe retrospectively investigated patients with ABAO who underwent MT, using modern stent retrievers and an aspiration device, between January 2015 and December 2017 at 12 comprehensive stroke centers. Functional outcomes and 90-day mortality were analyzed as primary outcomes. RESULTSForty-eight patients were included. Good outcome (modified Rankin Scale mRS 0-2) was achieved in 20/48 patients and the all-cause 90-day mortality rate was 25%. Successful recanalization (modified Thrombolysis In Cerebral Infarction [mTICI] grade 2b and 3) was achieved in 47/48 patients. National Institutes of Health Stroke Scale, posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS), DWI Brain Stem Score, mTICI (3 > 2b), and intracranial hemorrhage were significantly different between good and poor functional outcome groups. The occlusion site of BA was significantly different between patients with moderate outcome (mRS 0-3) versus others. We found that age, pc-ASPECTS and mTICI were significantly associated with functional outcomes in the logistic regression model. CONCLUSIONMT with stent retrievers and an aspiration device for ABAO results in high successful recanalization and good outcomes. Further studies are required to confirm our results.
Author	Tagami, Takashi Ota, Takahiro Kaneko, Junya Unemoto, Kyoko Matsumaru, Yuji Hirano, Teruyuki Amano, Tatsuo Shigeta, Keigo Shiokawa, Yoshiaki Ueda, Masayuki
Author_xml	– sequence: 1 givenname: Junya orcidid: 0000-0002-5979-332X surname: Kaneko fullname: Kaneko, Junya email: kanekoj@nms.ac.jp organization: Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan – sequence: 2 givenname: Takahiro orcidid: 0000-0002-5108-6719 surname: Ota fullname: Ota, Takahiro organization: Department of Neurosurgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan – sequence: 3 givenname: Takashi surname: Tagami fullname: Tagami, Takashi organization: Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan – sequence: 4 givenname: Kyoko surname: Unemoto fullname: Unemoto, Kyoko organization: Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan – sequence: 5 givenname: Keigo orcidid: 0000-0003-4300-4231 surname: Shigeta fullname: Shigeta, Keigo organization: Department of Neurosurgery, National Hospital Organization Disaster Medical Center, Tokyo, Japan – sequence: 6 givenname: Tatsuo surname: Amano fullname: Amano, Tatsuo organization: Department of Stroke and Cerebrovascular Medicine, Kyorin University, Tokyo, Japan – sequence: 7 givenname: Masayuki surname: Ueda fullname: Ueda, Masayuki organization: Department of Neurology and Stroke Medicine, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan – sequence: 8 givenname: Yuji surname: Matsumaru fullname: Matsumaru, Yuji organization: Division of Stroke Prevention and Treatment, Department of Neurosurgery, University of Tsukuba, Ibaraki, Japan – sequence: 9 givenname: Yoshiaki surname: Shiokawa fullname: Shiokawa, Yoshiaki organization: Department of Neurosurgery, Kyorin University, Tokyo, Japan – sequence: 10 givenname: Teruyuki surname: Hirano fullname: Hirano, Teruyuki email: terry@kyorin-u.ac.jp organization: Department of Stroke and Cerebrovascular Medicine, Kyorin University, Tokyo, Japan
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/31005761$$D View this record in MEDLINE/PubMed
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CitedBy_id	crossref_primary_10_1161_STROKEAHA_119_027472 crossref_primary_10_1016_j_jocn_2020_06_022 crossref_primary_10_1111_ane_13572 crossref_primary_10_1016_j_jocn_2020_01_073 crossref_primary_10_1016_j_jstrokecerebrovasdis_2020_104752 crossref_primary_10_1016_j_jstrokecerebrovasdis_2020_105374 crossref_primary_10_25259_SNI_903_2021 crossref_primary_10_1007_s11886_019_1217_6 crossref_primary_10_1016_j_wneu_2020_12_060 crossref_primary_10_1055_s_0040_1722638 crossref_primary_10_1007_s00234_021_02843_3 crossref_primary_10_1007_s00062_020_00964_5 crossref_primary_10_1016_j_clineuro_2020_105796 crossref_primary_10_1016_j_clineuro_2021_106504 crossref_primary_10_1007_s00415_024_12353_w crossref_primary_10_1161_SVIN_121_000147 crossref_primary_10_1016_j_jocn_2020_12_034 crossref_primary_10_5469_neuroint_2019_00290
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Keywords	RCT BSS LVO Aspiration IVT rtPA Acute basilar artery occlusion MT Successful recanalization OTR pc-ASPECTS ICH mTICI ABAO CTA Mechanical thrombectomy DWI Stent retriever TREAT IAT MRA BASICS
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Snippet	The effectiveness of mechanical thrombectomy (MT) for acute basilar artery occlusion (ABAO) remains unknown. We evaluated the feasibility, safety, and efficacy... OBJECTIVEThe effectiveness of mechanical thrombectomy (MT) for acute basilar artery occlusion (ABAO) remains unknown. We evaluated the feasibility, safety, and...
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SubjectTerms	Acute basilar artery occlusion Aspiration Mechanical thrombectomy Stent retriever Successful recanalization
Title	Endovascular treatment of acute basilar artery occlusion: Tama-REgistry of Acute Thrombectomy (TREAT) study
URI	https://dx.doi.org/10.1016/j.jns.2019.04.010 https://www.ncbi.nlm.nih.gov/pubmed/31005761 https://search.proquest.com/docview/2212727526
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