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  • Title: Endovascular treatment of basilar artery occlusion by manual aspiration thrombectomy.
    Author: Jankowitz BT, Aleu A, Lin R, Jumaa M, Kanaan H, Kostov D, Hammer M, Uchino K, Wechsler LR, Horowitz M, Jovin TG.
    Journal: J Neurointerv Surg; 2010 Jun; 2(2):110-4. PubMed ID: 21990589.
    Abstract:
    BACKGROUND AND PURPOSE: Basilar artery occlusion remains one of the most devastating subtypes of stroke. Intravenous and intra-arterial therapy have altered the natural history of this disease; however, clinical results remain poor. Therefore, exploring more aggressive and innovative management is warranted. METHODS: Six consecutive patients presenting with a basilar artery occlusion were treated with the same general algorithm of intra-arterial tissue plasminogen activator and mechanical thrombectomy with the Merci retrieval system. If complete recanalization was not achieved after two passes, manual syringe aspiration through a 4.3F catheter was employed. RESULTS: All interventions utilizing aspiration thrombectomy resulted in recanalization, with five out of six cases displaying TIMI3/TICI3 flow and one patient resulting in complete recanalization of the basilar artery with persistent thrombus in one P2 segment (TIMI2/TICI2B). All patients survived, with five out of six independent in activities of daily living at 3 months (mRS 0-2). CONCLUSIONS: Our small case series indicates that aspiration thrombectomy performed manually through a 4.3F catheter can facilitate recanalization of basilar artery occlusion with acceptable clinical outcomes.
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