Mechanical thrombectomy using the stent device in posterior circulation large Intracerebral artery occlusions

Abstract

Objective To evaluate the safety and effect of mechanical thrombectomy with the stent device in posterior circulation large intracerebral artery occlusions. Methods Arterial embolectomy with the stent device was carried out in 16 patients with posterior circulation large intracerebral artery occlusions(3.5 h than intravenous thrombolysis time window) in the NO.264th Hospital of People Liberation Army, including 8 cases with pure basilar artery occlusion, 7 cases with bilateral vertebral artery intracranial segment and basilar artery occlusion, 1 case with side of intracranial vertebral artery occlusion.The National Institutes of health neurological deficit score(NIHSS) score, Alberta stroke program early CT (ASPECTS) score, complications, clinical result were analyzed retrospectively. Results Among 16 cases, the time windows were from 7 to 18 h, the time from onset to reperfusion were (13.32±1.57) h. Successful recanalization was obtained in 15 patients(TICI=3), partial recanalization in 1 case(TICI=2a). Three cases with stent angioplasty.Survival in patients with NIHSS score decreased from (24.65±3.63) points on admission to (4.32±1.57) points after three weeks, with statistical difference(P<0.01). For mRs score at 90 d: 6 cases(37.5%) with 0-1, 4 cases(25%) with 2-3, 2 cases(12.5%) with 4-5, 4 cases died (25.0%, score ASPECTS 4-5). Conclusion The mechanical thrombectomy with the stent device within 24 h can get higher reperfusion rate, fewer complications, and significantly reduce the mortality rate and good clinical outcome in large intracerebral poster circulation artery occlusions patients. Key words: Intracerebral artery occlusions; Stent; Mechanical Thrombectomy; Posterior circulation; Stroke