A multimodal treatment of basilar artery re-occlusion - case report.

IF 1.6 4区医学 Q2 Medicine

Acta Clinica Belgica Pub Date : 2024-09-30 DOI:10.1080/17843286.2024.2409478

Budišić M, Kalousek V, Bosnar Puretić M, Pilepić L, Dežmalj Grbelja L, Lovrenčić Huzjan A, Gavrančić M, Roje Bedeković M

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引用次数: 0

Abstract

Background: Stroke due to basilar artery occlusion (BAO) is a severe neurovascular condition with only recently proven effectiveness of mechanical thrombectomy as treatment. Early re-occlusion of the basilar artery (RE-BAO) is an even more challenging form of stroke to treat, associated with poor outcomes and still no optimal treatment guidelines. There are only a few reported cases covering this topic thus far.

Case presentation: We present a 52-year-old male patient with RE-BAO treated with a combination of bridging intravenous (IV) tissue plasminogen activator (tPA), mechanical thrombectomy (MT), rescue intraarterial (IA) tPA, and after re-occlusion, repeated bridging IV tPA and repeated MT in a 75-hour time span.

Discussion: In previous trials applying IA tPA after MT showed promising results in patients with anterior circulation stroke. However, our case report implies that using a combined treatment of IV tPA before and IA tPA after MT in posterior circulation shows similar results.

Conclusion: To our knowledge, this is the first case of RE-BAO managed with the aforementioned multimodal treatment. Such an approach recently showed promising results in the anterior circulation, and our report supports the effectiveness of multimodal recanalization treatment in the posterior circulation as well.

查看原文本刊更多论文

基底动脉再闭塞的多模式治疗--病例报告。

背景：基底动脉闭塞（BAO）导致的中风是一种严重的神经血管疾病，机械性血栓切除术的治疗效果最近才得到证实。基底动脉早期再闭塞（RE-BAO）是一种治疗难度更大的卒中形式，预后差，至今仍无最佳治疗指南。迄今为止，关于这一主题的病例报道寥寥无几：我们介绍了一名 52 岁男性 RE-BAO 患者，他接受了桥接静脉注射组织纤溶酶原激活剂（tPA）、机械取栓术（MT）、挽救性动脉内 tPA 以及再闭塞后在 75 小时内重复桥接静脉注射 tPA 和重复 MT 的综合治疗：讨论：在之前的试验中，前循环卒中患者在 MT 后应用 IA tPA 取得了良好的效果。然而，我们的病例报告表明，在后循环患者中，在 MT 之前使用 IV tPA 和 MT 之后使用 IA tPA 的联合治疗也能取得类似的效果：据我们所知，这是首例采用上述多模式治疗的 RE-BAO 病例。据我们所知，这是第一例采用上述多模式治疗的 RE-BAO 病例。这种方法最近在前循环中取得了良好的效果，而我们的报告支持了多模式再通化治疗在后循环中的有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Clinica Belgica 医学-医学：内科

CiteScore

2.90

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.