Acute basilar thrombosis: Recanalization following intravenous thrombolysis is dependent on thrombus length

PloS One
Hendrik JanssenJuergen Lutz

Abstract

We investigated whether thrombus length measured in Computed Tomography Angiography (CTA) is predictive of the success rate of intravenous thrombolysis (IVT) in acute basilar occlusion and whether recanalization can be achieved by additional mechanical endovascular thrombectomy. In 51 patients with acute basilar thrombosis thrombus length was measured on CTA images before intravenous thrombolysis (IVT) with rt-PA was started. After 114 minutes on average success of IVT was evaluated either by CTA or DSA. Patients with persistent basilar occlusion and no major brainstem infarction on CT underwent endovascular recanalization. 87% of patients had no recanalization of basilar artery after IVT alone. The average thrombus length was 15 mm in patients with persistent basilar occlusion after IVT and 7 mm in patients with recanalization after IVT. Thrombi longer than 13 mm did not resolve after IVT alone and 80% of thrombi shorter than 13 mm did not resolve either. 41 patients were transferred to endovascular recanalization; endovascular therapy was performed successfully in 90% (37 / 41). Recanalization rates in acute basilar occlusion after IVT alone are low and dependent on thrombus length. Additional mechanical endovascular thrombec...Continue Reading

References

May 1, 1977·Journal of Neurosurgery·N Saeki, A L Rhoton
Jul 1, 1989·Journal of the Neurological Sciences·C FieschiL Bozzao
Oct 1, 1988·Stroke; a Journal of Cerebral Circulation·W HackeG J del Zoppo
Sep 1, 1984·Journal of Neurosurgery·F UmanskyW J Ray
Feb 1, 1995·Journal of Neurology, Neurosurgery, and Psychiatry·M HuemerG Ladurner
May 1, 1996·Stroke; a Journal of Cerebral Circulation·T BrandtW Hacke
May 18, 1999·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·G MarchalJ C Baron
Mar 16, 2004·Lancet·Werner HackeUNKNOWN NINDS rt-PA Study Group Investigators
Oct 21, 2004·JAMA : the Journal of the American Medical Association·Perttu J LindsbergMarkku Kaste
Jan 28, 2006·Stroke; a Journal of Cerebral Circulation·Perttu J Lindsberg, Heinrich P Mattle
Sep 25, 2008·International Journal of Stroke : Official Journal of the International Stroke Society·Volker PuetzUNKNOWN Calgary CTA Study Group
Sep 26, 2008·The New England Journal of Medicine·Werner HackeUNKNOWN ECASS Investigators
Aug 1, 2009·AJNR. American Journal of Neuroradiology·V PuetzA M Demchuk
Aug 8, 2009·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·I Q GrunwaldC Roth
Jul 9, 2011·Stroke; a Journal of Cerebral Circulation·Tiina SairanenUNKNOWN Helsinki Stroke Thrombolysis Registry (HSTR) Group
Feb 7, 2012·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Kay W P NgVijay K Sharma
Jun 12, 2014·Stroke; a Journal of Cerebral Circulation·Vladimir RohanJiri Ferda
Dec 18, 2014·The New England Journal of Medicine·Olvert A BerkhemerUNKNOWN MR CLEAN Investigators
Feb 12, 2015·The New England Journal of Medicine·Bruce C V CampbellUNKNOWN EXTEND-IA Investigators
Feb 12, 2015·The New England Journal of Medicine·Mayank GoyalUNKNOWN ESCAPE Trial Investigators
Apr 18, 2015·The New England Journal of Medicine·Jeffrey L SaverUNKNOWN SWIFT PRIME Investigators
Apr 18, 2015·The New England Journal of Medicine·Tudor G JovinUNKNOWN REVASCAT Trial Investigators
Sep 17, 2016·Journal of Neurointerventional Surgery·Fatih SekerMarkus A Möhlenbruch

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Citations

Dec 18, 2021·Acta Neurologica Scandinavica·Felipe Borelli Del GuerraAdriana Bastos Conforto

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Methods Mentioned

BETA
imaging technique

Software Mentioned

BASICS
SPSS Statistics
OsiriX Imaging

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