Strategy of double stent-retriever thrombectomy for acute distal basilar artery occlusion

  Objective  To explore the safety and efficacy of double stent-retriever thrombectomy in treatment of acute distal basilar artery occlusion.

  Methods  From January 2015 to May 2019, the imaging and clinical materials of 5 patients with acute distal basilar artery occlusion treated by double stent-retriever thrombectomy in center of cerebrovascular disease were analyzed retrospectively, including modified thrombolysis in cerebral infarction (mTICI), median score of the National Institutes of Health Stroke Scale (NIHSS) at 24 h and 7 days after operation, perioperative complications and score of modified Rankin Scale (MRS) within 90 days.

  Results  Among the 5 patients in this research, 3 patients selected double stent-retriever thrombectomy after failure of single stent thrombectomy for many times, and 2 patients directly selected double stent-retriever thrombectomy. All occluded vessels were recanalized successfully, and mTICI reached grades of 2b to 3. No intracranial hemorrhage was found by 3D-CT. The median NIHSS scores were 9.8 and 7.4 points at 24 h and 7 days after operation respectively. One patient died of pulmonary infection. Three patients were followed up for 3 months. The 90 d mRS was less than or equal to 2 points in three patients, and was more than 2 points in one patient.

  Conclusion  Double stent-retriever thrombectomy is safe and effective in the treatment of acute distal basilar artery occlusion with a high recanalization rate, which can be used as a remedy for the failure of conventional thrombectomy.