Distal protection of endovascular recanalization for symptomatic non-acute occlusion of vertebrobasilar artery

IF 1.9 3区医学 Q3 CLINICAL NEUROLOGY

Acta Neurochirurgica Pub Date : 2025-04-15 DOI:10.1007/s00701-025-06525-4

Qiuli Li, Xiaoxi Yao, Yuanbiao Lei, Haipeng Li, Liu Tu, Yi Zhang

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Abstract

Purpose

The research aimed to investigate the safety and efficacy of distal protection of endovascular recanalization for symptomatic non-acute occlusion of the intracranial vertebrobasilar artery.

Methods

8 consecutive patients with symptomatic non-acute VBA from April 2023 to April 2024 who underwent endovascular recanalization were retrospectively analyzed.

Results

8 patients (median age 56 years; mean pretreatment National Institutes of Health Stroke Scale (NIHSS) score 6; 87.5% male) presenting with recurrent transient ischemic attacks(TIAs) (n = 1) or strokes (n = 23) were treated from April 2023 to April 2024. Median time from symptoms onset to treatment was 21 days(range: 10–43). Median time from occlusion confirmed to treatment was 13 days(range:8–26). Among the 8 patients, 8 (100%) achieved successful recanalization. The rate of periprocedural complications was 25%(2/8). Periprocedural complication included one asymptomatic intracranial hemorrhage(asICH) and thrombus translocation. The median follow-up time was 9 months (range: 6–12), with no stroke or TIA. At 90 days, there were one death (unrelated to the procedure) and 75% patients with an available modified Rankin Scale (mRS) score achieved a good outcome (mRS score of 0–2).

Conclusion

The distal protection of stent retriever for endovascular recanalization for symptomatic non-acute occlusion of VBA is technically safe and may decrease procedure-related complications.

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血管内再通远端保护治疗症状性非急性椎基底动脉闭塞

目的探讨远端保护血管内再通治疗症状性非急性颅内椎基底动脉闭塞的安全性和有效性。方法回顾性分析2023年4月至2024年4月行血管内再通术治疗的8例有症状的非急性VBA患者。结果8例患者(中位年龄56岁；预处理美国国立卫生研究院卒中量表（NIHSS）平均得分6分；在2023年4月至2024年4月期间，87.5%的男性接受了复发性短暂性脑缺血发作（TIAs）（n = 1）或中风（n = 23）的治疗。从症状出现到治疗的中位时间为21天（范围：10-43天）。从确认闭塞到治疗的中位时间为13天（范围：8-26天）。8例患者中8例（100%）再通成功。围手术期并发症发生率为25%（2/8）。围手术期并发症包括一例无症状颅内出血（asICH）和血栓移位。中位随访时间为9个月（范围：6-12），无卒中或TIA。在第90天，有1例死亡（与手术无关），75%采用改良兰金量表（mRS）评分的患者获得了良好的预后（mRS评分为0-2）。结论在症状性非急性VBA闭塞的血管内再通术中，支架取物器远端保护在技术上是安全的，并可减少手术相关并发症。

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 Neurochirurgica 医学-临床神经学

CiteScore

4.40

自引率

4.20%

发文量

342

审稿时长

1 months

期刊介绍： The journal "Acta Neurochirurgica" publishes only original papers useful both to research and clinical work. Papers should deal with clinical neurosurgery - diagnosis and diagnostic techniques, operative surgery and results, postoperative treatment - or with research work in neuroscience if the underlying questions or the results are of neurosurgical interest. Reports on congresses are given in brief accounts. As official organ of the European Association of Neurosurgical Societies the journal publishes all announcements of the E.A.N.S. and reports on the activities of its member societies. Only contributions written in English will be accepted.