Abstract TP11: Thromboaspiraiton vs Stent Retriever Thrombectomy for Basilar Artery Occlusion

Abstract

Background: Thromboaspiration and stent retriever thrombectomy perform similarly in anterior circulation large vessel occlusions. We aim to compare performance of modern thromboaspiration against stent retriever technology in basilar artery occlusions. Methods: This was a retrospective analysis of a prospectively collected databank in a comprehensive stroke center. Inclusion criteria: thrombectomies in which stent-retrievers (Trevo or Solitaire) or modern thromboaspiration devices (Penumbra 5max, 64 or 68) were used as the first-line strategy from Sep2010-Mar2017. We excluded cases of combined retriever plus local aspiration. Primary outcome was first-pass reperfusion (modified TICI2b-3 with first pass). Results: Of 1204 thrombectomies within the study period, 68 patients were included (48 retrievers and 20 thromboaspiration cases). Age, gender, comorbidities, systolic blood pressure, NIHSS, IV tPA use, and last known normal to puncture times were comparable between groups. First-pass reperfusion was achieved in 58% of the retriever group vs 55% in the aspiration group (p=1.00). Parenchymal hematoma type-2 was observed in 2% vs 0% in the retriever and aspiration groups (p=1.00), respectively. At 90 days, good outcome (mRS0-2) was observed in 31% of the stent retriever patients compared to 41% in the aspiration group (p=0.55) while mortality was 53% and 41% (p=0.56), respectively. Conclusions: Stent retrievers and modern thromboaspiration were observed to have similar performance in achieving first pass reperfusion in patients with basilar artery occlusions. Further studies are warranted.