Endovascular treatment with Solitaire stent retrieval for stroke with acute vertebrobasilar occlusion

Abstract

Objective To explore the efficacy and safety of mechanical thrombectomy with Solitaire stent in revascularization of cerebral infraction patients due to vertebrobasilar occlusion and to identify its predictive factors for clinical outcomes. Methods The clinical data of patients with posterior circulation cerebral infarction attributable to vertebrobasilar occlusion, admitted to three hospitals from January 2015 to February 2016, were analyzed retrospectively. The re-canalization rate and complications were determined and the clinical outcomes were assessed using modified Rankin scale (mRS) three months after treatment. Predictive factors for clinical outcomes were studied. Results Mechanical thrombectomy with Solitaire stent was performed in 18 patients. Among them, 12 patients were male. The mean age of the patients was (61.6±8.1) years, the median pre-thrombectomy National Institutes of Health Stroke Scale (NIHSS) scores were 26.5 (19.8, 31.0), and the median Glasgow Coma Scale (GCS) scores were 8 (7.0, 10.0). Successful re-canalization (modified Thrombolysis in Cerebral Infarction: 2b or 3) was obtained in 16 patients (88.9%). A good prognosis (mRS scores≤2) was observed in 8 patients (44.4%). Four patients (22.2%) had symptomatic intracranial hemorrhage. The overall mortally rate was 27.8%. GCS and NIHSS scores between patients with good prognosis and poor prognosis were significantly different (P<0.05). Conclusion Mechanical thrombectomy with Solitaire stent can contribute to a high rate of re-canalizaton and improve the clinical outcomes in patients with vertebrobasilar occlusion. Key words: Vertebrobasilar occlusion; Stroke; Mechanical thrombectomy; Stent