BACKGROUND AND PURPOSE: Acute vertebrobasilar @entity385 is often associated with high morbidity and mortality with limited therapeutic options. Endovascular treatment with thrombolysis has offered some hope for affected @entity1 ; however, overall outcomes have been less than satisfactory. In this report, we present the results of our approach in six consecutive cases of acute vertebrobasilar @entity385 by combined proximal vessel stent placement and thrombolysis. METHODS: Six consecutive cases were retrospectively reviewed for the clinical outcome of @entity1 presenting to our institution with acute posterior circulation @entity64 who underwent cerebral revascularization including proximal arterial stent placement by using balloon-expandable coronary stents and intraarterial thrombolysis. All of these @entity1 were initially evaluated by @entity64 team neurologists and imaged with MR, including diffusion-weighted imaging documenting acute posterior circulation @entity64 . MR angiography of the circle of Willis was also obtained. Short-term follow-up was conducted to assess National Institutes of @entity64 scores (NIHSS) and modified Rankin scores. RESULTS: In these six cases, a combined approach of proximal arterial stent placement (five cases of vertebral artery origin and one case of carotid and subclavian stent placement plus vertebral artery revascularization) and thrombolysis was performed at variable times after @entity64 onset (range, 30 hours to 5 days). Four of the six @entity1 had good basilar artery recanalization (Thrombolysis in @entity583 [TIMI] grade 0-1 before tissue plasminogen activator thrombolysis and TIMI grade 2 after procedure). Four of six @entity1 had excellent immediate recovery and were discharged to an acute rehabilitation unit or their homes with improved neurologic symptoms and functional status. Two @entity1 died: one @entity1 presented with @entity772 at outset with an NIHSS of 38, and the other @entity1 probably had reocclusion of the basilar artery within 24 hours despite initial postprocedural improvement. CONCLUSION: We demonstrate that, in the setting of @entity64 , stent placement in combination with revascularization and thrombolysis is practical and allows quick access to a clot and simultaneously increases perfusion through collaterals during the thrombolytic process. In particular, basilar thrombolysis may be facilitated by proximal vertebral stent placement as concomitant @entity850 is common.

Combined stent placement and thrombolysis in acute vertebrobasilar XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity64 :: ('MESH:D020521', 'Disease') :: ['Health stroke', 'stroke', 'acute stroke'] @entity772 :: ('MESH:D003128', 'Disease') :: ['coma'] @entity583 :: ('MESH:D009203', 'Disease') :: ['Myocardial Infarction'] @entity850 :: ('MESH:D003251', 'Disease') :: ['atheromatous vertebrobasilar stenosis'] @entity385 :: ('MESH:D002544', 'Disease') :: ['ischemic stroke']
@entity385 :: (MESH:D002544,Disease) :: ['ischemic stroke']
