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Forced arterial suction thrombectomy with the penumbra reperfusion catheter in acute basilar artery occlusion: a retrospective comparison study in 2 Korean university hospitals.

Authors
Eom, YI  | Hwang, YH | Hong, JM  | Choi, JW  | Lim, YC  | Kang, DH | Kim, YW | Kim, YS | Kim, SY  | Lee, JS
Citation
AJNR. American journal of neuroradiology, 35(12). : 2354-2359, 2014
Journal Title
AJNR. American journal of neuroradiology
ISSN
0195-61081936-959X
Abstract
BACKGROUND AND PURPOSE: A performance of forced arterial suction thrombectomy was

not reported for the treatment of acute basilar artery occlusion. This study

compared revascularization performance between intra-arterial fibrinolytic

treatment and forced arterial suction thrombectomy with a Penumbra reperfusion

catheter in patients with acute basilar artery occlusion. MATERIALS AND METHODS:

Fifty-seven patients with acute basilar artery occlusion were treated with

intra-arterial fibrinolysis (n = 25) or forced arterial suction thrombectomy (n =

32). Baseline characteristics, successful revascularization rate, and clinical

outcomes were compared between the groups. RESULTS: Baseline characteristics, the

frequency of patients receiving intravenous recombinant tissue plasminogen

activator, and mean time interval between symptom onset and femoral puncture did

not differ between groups. The forced arterial suction thrombectomy group had a

shorter procedure duration (75.5 minutes versus 113.3 minutes, P = .016) and

higher successful revascularization rate (88% versus 60%, P = .017) than the

fibrinolysis group. Fair outcome, indicated by a modified Rankin Scale 0-3, at 3

months was achieved in 34% of patients undergoing forced arterial suction

thrombectomy and 8% of patients undergoing fibrinolysis (P = .019), and the

mortality rate was significantly higher in the fibrinolysis group (25% versus

68%, P = .001). Multiple logistic regression analysis identified the forced

arterial suction thrombectomy method as an independent predictor of fair outcome

with adjustment for age, sex, initial NIHSS score, and the use of intravenous

recombinant tissue plasminogen activator (odds ratio, 7.768; 95% CI,

1.246-48.416; P = .028). CONCLUSIONS: In acute basilar artery occlusion, forced

arterial suction thrombectomy demonstrated a higher revascularization rate and

improved clinical outcome compared with traditional intra-arterial fibrinolysis.

Further clinical trials with the newer Penumbra catheter are warranted.
MeSH

DOI
10.3174/ajnr.A4045
PMID
25034774
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Neurology
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
Journal Papers > School of Medicine / Graduate School of Medicine > Neurosurgery
Ajou Authors
김, 선용  |  엄, 영인  |  이, 진수  |  임, 용철  |  최, 진욱  |  홍, 지만
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