Endovascular recanalization of acute intracranial vertebrobasilar artery occlusion using local fibrinolysis and additional balloon angioplasty
| Autor: | Yoshiko Sagara, Mika Okahara, Yuzo Hori, Toshi Abe, Junji Kashiwagi, Hiro Kiyosue, Hiromu Mori, Shuichi Tanoue |
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| Rok vydání: | 2010 |
| Předmět: |
Male
endocrine system medicine.medical_specialty Percutaneous medicine.medical_treatment Arterial Occlusive Diseases Balloon Severity of Illness Index Angioplasty medicine.artery Occlusion Fibrinolysis Vertebrobasilar Insufficiency medicine Basilar artery Humans Thrombolytic Therapy Radiology Nuclear Medicine and imaging Aged Aged 80 and over medicine.diagnostic_test business.industry Brain Interventional radiology Thrombolysis Middle Aged Subarachnoid Hemorrhage Combined Modality Therapy Surgery Treatment Outcome Basilar Artery Acute Disease Female Neurology (clinical) Radiology Cardiology and Cardiovascular Medicine business Angioplasty Balloon |
| Zdroj: | Neuroradiology. 52:361-370 |
| ISSN: | 1432-1920 0028-3940 |
| DOI: | 10.1007/s00234-010-0658-9 |
| Popis: | Vertebrobasilar artery occlusion (VBO) produces high mortality and morbidity due to low recanalization rate utilization in endovascular therapy. The use of percutaneous transluminal angioplasty (PTA) to improve recanalization rate additional to local intra-arterial fibrinolysis (LIF) was investigated in this study. Results obtained following recanalization therapy in acute intracranial VBO are reported.Eighteen consecutive patients with acute VBO underwent LIF with or without PTA, from August 2000 to May 2006. Eight patients were treated using LIF alone, and ten required additional PTA. Rate of recanalization, neurological status before treatment, and clinical outcomes were evaluated.Of 18 patients, 17 achieved recanalization. One procedure-related complication of subarachnoid hemorrhage occurred. Overall survival rate was 94.4% at discharge. Seven patients achieved good outcomes [modified Rankin scale (mRS) 0-2], and the other 11 had poor outcomes (mRS 3-6). Five of six patients who scored 9-14 on the Glasgow Coma Scale (GCS) before treatment displayed good outcomes, whereas ten of 12 patients who scored 3-8 on the GCS showed poor outcomes. GCS prior to treatment showed a statistically significant correlation to outcomes (p0.05). Moreover, the National Institutes of Health Stroke Scale (NIHSS) before treatment correlated well with mRS (correlation coefficient 0.487). No statistical difference between the good and poor outcome groups was observed for the duration of symptoms, age, etiology, and occlusion site.Endovascular recanalization can reduce mortality and morbidity of acute VBO. Good GCS and NIHSS scores prior to treatment can predict the efficacy of endovascular recanalization. |
| Databáze: | OpenAIRE |
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