Coronary stent implantation for acute basilar artery occlusion with underlying stenosis.

Abstract

AIMS:

Our aim was to study the effectiveness of coronary stent implantation during the endovascular treatment (EVT) of acute basilar artery occlusion (BAO) with occlusion-underlying intracranial atherosclerotic stenosis (ICAS).

METHODS AND RESULTS:

We retrospectively analysed 91 consecutive BAO patients who underwent EVT between February 2014 and January 2019 in a single, high-volume neurointerventional centre. We studied the effect of immediate coronary stent implantation on the clinical outcome of BAO with occlusion-underlying stenosis. BAO patients with underlying ICAS (n=41) were characterised by longer symptom-onset-to-reperfusion times (231 min vs 173 min, p=0.0020), lower TICI 2b-3 reperfusion rates (65.85% vs 90.00%, p=0.0084), and higher overall mortality (HR 2.021, p=0.0417) compared to the BAO cases without ICAS (n=50). The patients undergoing stenting (n=18) had lower residual basilar artery (BA) stenosis (14.7% vs 81.0%, p<0.0001), higher chance for functional recovery (OR 7.6, p=0.0250) and higher chance of survival (HR 4.163, p=0.0026) compared to the BAO-ICAS cases treated without coronary stents (n=21).

CONCLUSIONS:

The immediate treatment of the occlusion-underlying stenosis with coronary stents and dual antiplatelet therapy (DAPT) in BAO was associated with improved overall survival and better functional outcomes.

• Authors: Sándor Nardai, Balázs Kis, István Gubucz, Zsolt Berentei, Zsolt Vajda, Péter Orosz, András Nagy, Csaba Óváry, Zoltán Nagy, István Szikora
• Journal: EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology (EuroIntervention) Vol. 16 Issue 12 Pg. e1021-e1028 (Dec 18 2020) ISSN: 1969-6213 [Electronic] France
• PMID: 31355751 (Publication Type: Journal Article)

Topics

• Basilar Artery (diagnostic imaging, surgery)
• Constriction, Pathologic
• Endovascular Procedures
• Humans
• Retrospective Studies
• Stents
• Stroke
• Thrombectomy
• Treatment Outcome
• Vertebrobasilar Insufficiency (complications, diagnostic imaging, surgery)