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Basilar Artery Occlusion Thrombectomy Technique: An International Survey of Practice Patterns

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机构: [1]Boston Univ, Dept Radiol, Boston Med Ctr, Chobanian & Avedisian Sch Med, Boston, MA USA [2]Boston Univ, Dept Neurol, Boston Med Ctr, Chobanian & Avedisian Sch Med, Boston, MA USA [3]Imperial Coll Healthcare NHS Trust, Charing Cross Hosp, Dept Stroke Med, London, England [4]Ctr Hosp Univ Montreal, Dept Radiol, Intervent Neuroradiol Div, Quebec City, PQ, Canada [5]Cooper Univ Hosp, Cooper Neurol Inst, Camden, NJ USA [6]Foshan Sanshui Dist Peoples Hosp, Dept Neurol, Foshan, Guangdong, Peoples R China [7]Beijing Tiantan Hosp, Intervent Neuroradiol, Beijing, Peoples R China [8]St Antonius Hosp, Dept Neurol, Nieuwegein, Netherlands [9]Univ Sci & Technol China, Stroke Ctr, Hefei, Anhui, Peoples R China [10]Univ Sci & Technol China, Dept Neurol, Affiliated Hosp 1, Div Life Sci & Med, Hefei, Anhui, Peoples R China [11]Nanjing Univ, Med Sch, Affiliated Jinling Hosp, Dept Neurol, Nanjing, Peoples R China [12]Xuanwu Hosp, Dept Neurosurg, Beijing, Peoples R China [13]Hop Foch, Stroke Ctr Neurol Div, Suresnes, France [14]Xuanwu Hosp, Dept Neurol, Beijing, Peoples R China [15]Univ Melbourne, Royal Melbourne Hosp, Melbourne Brain Ctr, Dept Med & Neurol, Parkville, Vic, Australia [16]Helsinki Univ Hosp, Dept Neurol, Helsinki, Finland [17]Univ Bern, Bern Univ Hosp, Dept Neurol, Bern, Switzerland [18]Univ Basel, Basel Univ Hosp, Dept Neurol, Basel, Switzerland [19]Univ Hosp Bern, Inselspital, Inst Diag & Intervent Neuroradiol, Bern, Switzerland [20]Osaka Natl Hosp, Natl Hosp Org, Dept Stroke Neurol, Osaka, Japan [21]Tech Univ Dresden, Univ Hosp Carl Gustav Carus, Dresden Neurovasc Ctr, Dept Neurol, Dresden, Germany [22]Univ Laquila, Dept Biotechnol & Appl Clin Sci, Neurosci Sect, Laquila AQ, Italy [23]Akershus Univ Hosp, Dept Neurol, Lorenskog, Norway [24]Univ Oslo, Dept Gen Practice, Oslo, Norway [25]Leuven Univ Hosp, Neurol Dept, Leuven, Belgium [26]Imperial Coll Healthcare NHS Trust, Charing Cross Hosp, Dept Radiol, London, England [27]Istanbul Univ, Koc Univ Hosp, Intervent Neuroradiol, Istanbul, Turkiye [28]Univ Hosp San Giovanni Dio & Ruggi Aragona, Neuroradiol, Salerno, Italy [29]SUNY Upstate, Dept Neurol, Syracuse, NY USA [30]Royal North Shore Hosp, Sydney, NSW, Australia [31]UT Southwestern, Dept Neurol Radiol, Houston, TX USA [32]Westchester Med Ctr, Dept Neurol, Valhalla, NY USA [33]Zhejiang Univ, Hangzhou Peoples Hosp 1, Dept Neurol, Sch Med, Hangzhou, Peoples R China [34]115 People Hosp, Cerebrovasc Dis Dept, Ho Chi Minh City, Vietnam [35]Hanoi Med Univ, Bach Mai Hosp, Stroke Ctr, Hanoi, Vietnam [36]Vietnam Natl Univ, Univ Med & Pharm, Hanoi, Vietnam [37]Brest Univ Hosp, Radiol Dept, Brest, France [38]Bicetre Hosp, APHP, Dept Intervent Neuroradiol, NEURI Brain Vasc Ctr, Le Kremlin Bicetre, France [39]Hosp Foch, Dept Diag & Intervent Neuroradiol, Suresnes, France [40]Univ Klin Hamburg Eppendorf, Klin & Poliklin Intervent Neuroradiol, Hamburg, Germany [41]Calif Pacific Med Ctr, Dept Neurol, San Francisco, CA USA [42]Wellstar Neurosci Inst, Dept Neurol Neurosurg, Charleston, SC USA [43]Barrow Neurol Inst, Dept Neurol Neurosurg, Phoenix, AZ USA [44]Ajou Univ, Ajou Univ Hosp, Dept Neurol, Suwon, South Korea [45]Univ Klin Hamburg Eppendorf, Klin & Poliklin Neurol, Hamburg, Germany [46]Heidelberg Univ Hosp, Dept Neurol, Heidelberg, Germany [47]Klinikum Ludwigshafen, Dept Neurol, Ludwigshafen, Germany [48]Army Med Univ, Xinqiao Hosp, Dept Neurol, Chongqing, Peoples R China [49]Army Med Univ, Affiliated Hosp 2, Chongqing, Peoples R China [50]Bon Secours Mercy Hlth, St Vincent Hosp, Neurosci & Stroke Program, Toledo, OH USA [51]Univ Basel Hosp, Dept Neuroradiol, Basel, Switzerland [52]903rd Hosp Peoples Liberat Army, Dept Neurol, Hangzhou, Peoples R China
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关键词: basilar artery contact aspiration intracranial angioplasty intracranial stenting ischemic stroke stent retriever thrombectomy

摘要:
BACKGROUND: Two recent trials demonstrated a benefit for endovascular therapy (EVT) in the treatment of basilar artery occlusion (BAO). In light of the expected increase in the use of EVT for BAO, we sought to understand the technique preferences of neurointerventionalists performing EVT for BAO. METHODS: We conducted an international online survey of physician opinions on the use of EVT in BAO between January and March 2022. The survey was distributed through stroke and neurointerventional organizations. Survey questions examined selection of patients for the procedure and the techniques currently used for EVT in BAO. Responses from neurointerventionalists were analyzed. RESULTS: More than 3000 participants were invited yielding 1245 respondents, of whom 543 were classified as neurointerventionalists across 52 countries and included in this analysis. Most neurointerventionalists would proceed to EVT for occlusions of the V4 segment, the basilar artery, or the posterior cerebral artery, without regard for prior intravenous thrombolysis. For BAO of embolic etiology, aspiration only thrombectomy was the preferred method of 50.3% of neurointerventionalists. For BAO of intracranial atherosclerotic disease etiology, combined stent retriever and aspiration thrombectomy was the preferred method of 40.5% of neurointerventionalists. The majority of neurointerventionalists (88.0%) would proceed to stenting after 3 or fewer failed passes for patients with BAO of intracranial atherosclerotic disease etiology. In patients undergoing stenting, aspirin and clopidogrel was the most common antiplatelet regime (52.4%). CONCLUSIONS: Among the surveyed neurointerventionalists, the most common techniques for EVT of patients with BAO were contact aspiration or combined stent retriever with aspiration thrombectomy. For patients with BAO due to intracranial atherosclerotic disease, the majority of neurointerventionalists were willing to stent and do so most often after 3 or fewer failed passes and with the use of dual antiplatelet medications. Further study is needed to determine the optimal technique for EVT of BAO with or without intracranial atherosclerotic disease.

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Q3 CLINICAL NEUROLOGY Q3 PERIPHERAL VASCULAR DISEASE

影响因子: 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版]

第一作者:
第一作者机构: [1]Boston Univ, Dept Radiol, Boston Med Ctr, Chobanian & Avedisian Sch Med, Boston, MA USA [2]Boston Univ, Dept Neurol, Boston Med Ctr, Chobanian & Avedisian Sch Med, Boston, MA USA
通讯作者:
通讯机构: [1]Boston Univ, Dept Radiol, Boston Med Ctr, Chobanian & Avedisian Sch Med, Boston, MA USA [2]Boston Univ, Dept Neurol, Boston Med Ctr, Chobanian & Avedisian Sch Med, Boston, MA USA [3]Imperial Coll Healthcare NHS Trust, Charing Cross Hosp, Dept Stroke Med, London, England [*1]Boston Med Ctr, 1 Boston Med Ctr, Boston, MA 02118 USA [*2]Imperial Coll Healthcare NHS Trust, Charing Cross Hosp, London W6 8RF, England
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