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BMC Neurology
Published in: BMC Neurology 1/2019

Open Access 01-12-2019 | Stroke | Research article

Intracranial mechanical thrombectomy of large vessel occlusions in the posterior circulation using SAVE

Authors: Volker Maus, Hanna Styczen, Jan Liman, Ilko Maier, Alex Brehm, Ioannis Tsogkas, Marios-Nikos Psychogios

Published in: BMC Neurology | Issue 1/2019

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Abstract

Background

Mechanical thrombectomy (MT) using stent retriever assisted vacuum-locked extraction (SAVE) is a promising method for anterior circulation strokes. We present our experience with SAVE for large vessel occlusions (LVO) of the posterior circulation.

Methods

We retrospectively analyzed 66 consecutive MT patients suffering from LVO of the posterior circulation. Primary endpoints were first-pass and overall complete/near complete reperfusion, defined as a modified thrombolysis in cerebral infarction (mTICI) score of 2c and 3. Secondary endpoints contained number of passes, time interval from groin puncture to reperfusion and rate of postinterventional symptomatic intracranial hemorrhage (sICH).

Results

Median age was 75 years (interquartile range (IQR) 54–81 years). Baseline median National Institutes of Health stroke scale (NIHSS) was 13 (IQR 8–21). Fifty-five (83%) patients had LVO of the basilar artery and 11 (17%) of the posterior cerebral artery. Eighteen (27%) patients were treated with SAVE and 21 (32%) with aspiration only. First pass mTICI2c or 3 and overall mTICI2c or 3 were documented in 11/18 (61%) and 14/18 (78%) with SAVE and in 4/21 (19%) and 13/21 (33%) with aspiration only. Median attempt was 1 (IQR 1–2) with SAVE and 2 (IQR 1–4) with aspiration (p = 0.0249). Median groin to reperfusion time did not differ significantly between groups. The rate of sICH was 5% without any complications in the SAVE cohort.

Conclusion

Mechanical thrombectomy of posterior large vessel occlusions with SAVE is feasible, safe, and effective with high rates of near-complete and complete reperfusion.
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Metadata
Title
Intracranial mechanical thrombectomy of large vessel occlusions in the posterior circulation using SAVE
Authors
Volker Maus
Hanna Styczen
Jan Liman
Ilko Maier
Alex Brehm
Ioannis Tsogkas
Marios-Nikos Psychogios
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2019
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-019-1428-x

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