Staged escalation therapy in acute basilar artery occlusion: Intravenous thrombolysis and on-demand consecutive endovascular mechanical thrombectomy: Preliminary experience in 16 patients

Stroke

Volumn 39, Issue 5, 2008, Pages 1496-1500

  Pfefferkorn, Thomas ^a,b   Mayer, Thomas E ^b   Opherk, Christian ^a   Peters, Nils ^a   Straube, Andreas ^a   Pfister, Hans Walter ^a   Holtmannspötter, Markus ^b   Müller Schunk, Stefanie ^b   Wiesmann, Martin ^b   Dichgans, Martin ^a  

^a Department of Neurology ^*  (Germany)

^b LUDWIG MAXIMILIANS UNIVERSITY   (Germany)

Author keywords

Basilar artery occlusion; Mechanical thrombectomy; Thrombolysis

Indexed keywords

ACETYLSALICYLIC ACID; ALTEPLASE; HEPARIN; TIROFIBAN; ANTICOAGULANT AGENT; ANTITHROMBOCYTIC AGENT; FIBRINOLYTIC AGENT; TISSUE PLASMINOGEN ACTIVATOR;

ADULT; AGED; ARTICLE; BASILAR ARTERY; CLINICAL ARTICLE; CLINICAL PROTOCOL; COMPUTED TOMOGRAPHIC ANGIOGRAPHY; CONTROLLED STUDY; FEMALE; FIBRINOLYTIC THERAPY; HUMAN; MALE; OCCLUSIVE CEREBROVASCULAR DISEASE; PERCUTANEOUS THROMBECTOMY; PRIORITY JOURNAL; RECANALIZATION; RECURRENT DISEASE; BRAIN ANGIOGRAPHY; BRAIN STEM INFARCTION; COMPUTER ASSISTED TOMOGRAPHY; DRUG EFFECT; EMERGENCY HEALTH SERVICE; FEASIBILITY STUDY; INSTRUMENTATION; INTRAVENOUS DRUG ADMINISTRATION; METHODOLOGY; MIDDLE AGED; NUCLEAR MAGNETIC RESONANCE IMAGING; PREOPERATIVE CARE; RADIOGRAPHY; STANDARD; THROMBECTOMY; TIME; TREATMENT OUTCOME; UNIVERSITY HOSPITAL; VERTEBROBASILAR INSUFFICIENCY;

ACADEMIC MEDICAL CENTERS; ADULT; AGED; AGED, 80 AND OVER; ANTICOAGULANTS; BASILAR ARTERY; BRAIN STEM INFARCTIONS; CEREBRAL ANGIOGRAPHY; CLINICAL PROTOCOLS; EMERGENCY MEDICAL SERVICES; FEASIBILITY STUDIES; FEMALE; FIBRINOLYTIC AGENTS; HUMANS; INJECTIONS, INTRAVENOUS; MAGNETIC RESONANCE IMAGING; MALE; MIDDLE AGED; PLATELET AGGREGATION INHIBITORS; PREOPERATIVE CARE; THROMBECTOMY; THROMBOLYTIC THERAPY; TIME FACTORS; TISSUE PLASMINOGEN ACTIVATOR; TOMOGRAPHY, X-RAY COMPUTED; TREATMENT OUTCOME; VERTEBROBASILAR INSUFFICIENCY;

EID: 44449134806     PISSN: 00392499     EISSN: None     Source Type: Journal    
DOI: 10.1161/STROKEAHA.107.505123     Document Type: Article

References (21)

1. Hacke W, Zeumer H, Ferbert A, Bruckmann H, del Zoppo GJ. Intra-ar-terial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease. Stroke. 1988;19:1216-1222.
2. Brandt T, von Kummer R, Muller-Kuppers M, Hacke W. Thrombolytic therapy of acute basilar artery occlusion. Variables affecting recanaliza-tion and outcome. Stroke. 1996;27:875-881.
3. Archer CR, Horenstein S. Basilar artery occlusion: clinical and radiological correlation. Stroke. 1977;8:383-390.
4. Schulte-Altedorneburg G, Hamann GF, Mull M, Kuhne D, Liebetrau M, Weber W, Bruckmann H, Mayer TE. Outcome of acute vertebrobasilar occlusions treated with intra-arterial fibrinolysis in 180 patients. AJNR Am J Neuroradiol. 2006;27:2042-2047.
5. Lindsberg PJ, Mattle HP. Therapy of basilar artery occlusion: a systematic analysis comparing intra-arterial and intravenous thrombolysis. Stroke. 2006;37:922-928.
6. Arnold M, Nedeltchev K, Schroth G, Baumgartner RW, Remonda L, Loher TJ, Stepper F, Sturzenegger M, Schuknecht B, Mattle HP. Clinical and radiological predictors of recanalisation and outcome of 40 patients with acute basilar artery occlusion treated with intra-arterial thrombolysis. J Neurol Neurosurg Psychiatry. 2004;75:857-862.
7. Eckert B, Kucinski T, Pfeiffer G, Groden C, Zeumer H. Endovascular therapy of acute vertebrobasilar occlusion: early treatment onset as the most important factor. Cerebrovasc Dis. 2002;14:42-50.
8. Levy EI, Firlik AD, Wisniewski S, Rubin G, Jungreis CA, Wechsler LR, Yonas H. Factors affecting survival rates for acute vertebrobasilar artery occlusions treated with intra-arterial thrombolytic therapy: a meta-analytical approach. Neurosurgery. 1999;45:539-545.
9. Muller R, Pfefferkorn T, Vatankhah B, Mayer TE, Schenkel J, Dichgans M, Sander D, Audebert HJ. Admission facility is associated with outcome of basilar artery occlusion. Stroke. 2007;38:1380 -1383.
10. Schellinger PD, Hacke W. Intra-arterial thrombolysis is the treatment of choice for basilar thrombosis: pro. Stroke. 2006;37:2436 -2437.
11. Lindsberg PJ, Soinne L, Tatlisumak T, Roine RO, Kallela M, Happola O, Kaste M. Long-term outcome after intravenous thrombolysis of basilar artery occlusion. JAMA. 2004;292:1862-1866.
12. Junghans U, Seitz RJ, Wittsack HJ, Aulich A, Siebler M. Treatment of acute basilar artery thrombosis with a combination of systemic alteplase and tirofiban, a nonpeptide platelet glycoprotein IIb/IIIa inhibitor: report of four cases. Radiology. 2001;221:795-801.
13. Eckert B, Koch C, Thomalla G, Kucinski T, Grzyska U, Roether J, Alfke K, Jansen O, Zeumer H. Aggressive therapy with intravenous abciximab and intra-arterial rtPA and additional PTA/stenting improves clinical outcome in acute vertebrobasilar occlusion. Combined local fibrinolysis and intravenous abciximab in acute vertebrobasilar stroke treatment (FAST). Results of a Multicenter Study. Stroke. 2005;36:1160-1165.
14. Mayer TE, Hamann GF, Schulte-Altedorneburg G, Brückmann H. Treatment of vertebrobasilar occlusion by using a coronary waterjet thrombectomy device: a pilot study. AJNR Am J Neuroradiol. 2005;26: 1389-1394.
15. Qureshi AI, Siddiqui AM, Suri MF, Kim SH, Ali Z, Yahia AM, Lopes DK, Boulos AS, Ringer AJ, Saad M, Guterman LR, Hopkins LN. Aggressive mechanical clot disruption and low-dose intra-arterial third-generation thrombolytic agent for ischemic stroke: a prospective study. Neurosurgery. 2002;51:1319-1327.
16. Nedeltchev K, Remonda L, Do DD, Brekenfeld C, Ozdoba C, Arnold M, Mattle HP, Schroth G. Acute stenting and thromboaspiration in basilar artery occlusions due to embolism from the dominating vertebral artery. Neuroradiology. 2004;46:686-691.
17. Smith WS, for the Multi MERCI Investigators. Safety of mechanical throm-bectomy and intravenous tissue plasminogen activator in acute ischemic stroke. Results of the multi Mechanical Embolus Removal in Cerebral Ischemia (MERCI) trial, part I. AJNR Am J Neuroradiol. 2006;27:1177-1182.
18. Chesebro JH, Knatterud G, Roberts R, Borer J, Cohen LS, Dalen J, Dodge HT, Francis CK, Hillis D, Ludbrook P, et al. Thrombolysis in Myocardial Infarction (TIMI) Trial, Phase I: A comparison between intravenous tissue plasminogen activator and intravenous streptokinase Clinical findings through hospital discharge. Circulation. 1987;76:142-154.
19. Newcommon NJ, Green TL, Haley E, Cooke T, Hill MD. Improving the assessment of outcomes in stroke: use of a structured interview to assign grades on the modified Rankin Scale. Stroke. 2003;34:377-378.
20. Wahlgren N, Ahmed N, Davalos A, Ford GA, Grond M, Hacke W, Hennerici MG, Kaste M, Kuelkens S, Larrue V, Lees KR, Roine RO, Soinne L, Toni D, Vanhooren G; SITS-MOST Investigators. Thrombol-ysis with alteplase for acute ischaemic stroke in the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST): an observational study. Lancet. 2007;369:275-282.
21. Thomalla G, Schwark C, Sobesky J, Bluhmki E, Fiebach JB, Fiehler J, Zaro Weber O, Kucinski T, Juettler E, Ringleb PA, Zeumer H, Weiller C, Hacke W, Schellinger PD, Rother J; MRI in Acute Stroke Study Group of the German Competence Network Stroke. Outcome and symptomatic bleeding complications of intravenous thrombolysis within 6 hours in MRI-selected stroke patients: comparison of a German multicenter study with the pooled data of ATLANTIS, ECASS, and NINDS tPA trials. Stroke. 2006;37:852-858.