Endovascular Treatment Of Acute Basilar Artery Occlusion

Objective:To explore the safety and efficacy of endovascular mechanical thrombolytic therapy in patients with acute basilar artery occlusion.Materials and methods:From January 2016 to December 2017,45 patients were admitted to neurology department of the first hospital of jilin university.The onset time in 0 ~ 24 h in patients with acute basilar artery occlusion.According to the specific criteria,proceed intravascular therapy for acute basilar artery occlusion and observation of curative effect.The age,gender,consciousness status,preoperative NIHSS score and mRS score were collected.Of 45 patients with acute basilar artery occlusion,endovascular treatment should observe 90 d to clinical prognosis for mRS 0~2,3~4 points,the proportion of5~6 points,basal artery recanalization in patients with intraoperative and postoperative NIHSS score decreased acuity within 24 ± 2 h ? 8 or NIHSS score of 0 ~ 2 points number of patients and ratio,mortality of 90 d,the incidence of symptomatichemorrhage and the incidence of perioperative complications.Results:The immediate vascular recirculation rate(mTICI 2b ~ 3)was as high as 93.3%(42/45),and the basilar artery was not opened in3 patients(2 cases of arterial rupture and 1 arterial interlayer).Postoperatively,standardized treatment of anti-platelet aggregation,nutritional nerve and rehabilitation function training was performed,and 17 cases of functional independent(mRS 0 ~ 2 points)were performed at 90 d,accounting for 37.8%.The number of patients with mRS 3-4 in 90 days was 16,accounting for 35.6%.The number of patients with poor prognosis(mRS 5 ~ 6)was 12,accounting for 26.7%.After the operation,there was a good reaction:NIHSS score decreased by more than 8 points,24 cases accounted for 53.3%,NIHSS score was 0 ~ 2,4 cases accounted for 8.9%.This study 90 d mortality was 24.4%(11/45),24±2 hours for symptomatic hemorrhage,cerebral hemorrhage and subarachnoid hemorrhage rate was 20.0%(9/45),3 cases of symptomatic cerebral hemorrhage,6 cases of subarachnoid hemorrhage.3cases of symptomatic cerebral hemorrhage 2 cases died,in 6cases of subarachnoid hemorrhage 4 cases were dead(including 2cases of artery rupture),2 cases of basilar artery dissection 1 casedeath,4 cases died of 10 patients with severe pneumonia.There were no peripheral arterial dissection,pseudoaneurysm,inguinal or retroperitoneal hematoma.Conclusion:1.In this study,the treatment of acute basilar artery occlusion with intravascular mechanical thrombolysis has high blood vessel recirculation rate,indicating that the technique is feasible.2.This study shows that the treatment of acute basilar artery occlusion by intravascular mechanical thrombolysis can significantly reduce the mortality of patients and improve the prognosis of patients,indicating that it has certain curative effect.3.Compared with the high mortality and disability rate of acute basilar artery occlusion,the complications of endovascular treatment may be accepted.