|Title:||Endovascular Treatment Outcome and CT Angiography Findings in Acute Basilar Artery Occlusion with and without Underlying Intracranial Atherosclerotic Stenosis||Authors:||Lin Y.-H.
|Issue Date:||2020||Journal Volume:||31||Journal Issue:||5||Start page/Pages:||747-753||Source:||Journal of Vascular and Interventional Radiology||Abstract:||
Purpose: To compare clinical characteristics and treatment outcomes of intra-arterial thrombectomy (IAT) in acute basilar artery occlusion (BAO) with and without underlying intracranial atherosclerotic stenosis (ICAS) and to investigate the usefulness of preprocedural CT angiography findings in the diagnosis of ICAS. Materials and Methods: Twenty patients who received IAT for acute BAO between September 2014 and March 2019 were included. Additional therapies such as angioplasty, stent placement, and tirofiban infusion were provided while treating ICAS. Clinical and angiographic results of treatment were recorded. Preprocedural CT angiography findings in ICAS and non-ICAS groups were compared to assess (i) basilar tip opacification, (ii) partial occlusion, (iii) presence of convex border, (iv) occlusion segment longer than two thirds of the basilar artery or 20 mm, (v) dense basilar artery, and (vi) wall calcification in the occluded segment. Results: Among the 20 patients (mean age, 71.3 y; mean stroke score, 24.8), optimal recanalization was achieved in 19 (95%). Three patients had good clinical outcomes. There were 6 patients with underlying ICAS. No difference was observed between ICAS and non-ICAS groups in terms of optimal angiographic recanalization and good outcome. On CT angiography, basilar tip occlusion (100% vs 29%), partial occlusion (100% vs 83%), and long occlusion length (100% vs 14%) significantly differed between the groups (P ? .01). Conclusions: In acute BAO, underlying ICAS does not affect optimal recanalization rate or clinical outcome. Preprocedural CT angiography is a potentially useful tool to detect it. ? 2019 SIR
|URI:||https://scholars.lib.ntu.edu.tw/handle/123456789/516181||ISSN:||1051-0443||DOI:||10.1016/j.jvir.2019.09.002||metadata.dc.subject.other:||iohexol; iopromide; tirofiban; tissue plasminogen activator; acute disease; aged; angioplasty; artery calcification; Article; basilar artery; basilar artery obstruction; cerebrovascular accident; clinical article; clinical outcome; computed tomographic angiography; diagnostic accuracy; diagnostic test accuracy study; endovascular surgery; female; human; intraarterial thrombectomy; intracranial atherosclerotic stenosis; length; male; neuroimaging; peripheral occlusive artery disease; predictive value; priority journal; recanalization; retrospective study; sensitivity and specificity; thrombectomy; acute disease; adverse event; brain angiography; brain atherosclerosis; brain circulation; comparative study; diagnostic imaging; factual database; middle aged; multidetector computed tomography; pathophysiology; treatment outcome; vertebrobasilar insufficiency; very elderly; Acute Disease; Aged; Aged, 80 and over; Cerebral Angiography; Cerebrovascular Circulation; Computed Tomography Angiography; Databases, Factual; Endovascular Procedures; Female; Humans; Intracranial Arteriosclerosis; Male; Middle Aged; Multidetector Computed Tomography; Predictive Value of Tests; Retrospective Studies; Thrombectomy; Treatment Outcome; Vertebrobasilar Insufficiency
|Appears in Collections:||醫學院附設醫院 (臺大醫院)|
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