1,028 results match your criteria Basilar Artery Thrombosis


Postoperative antiplatelet therapy in the treatment of complex basilar apex aneurysms implementing Hunterian ligation and extracranial-to-intracranial bypass: review of the literature with an illustrative case report.

World Neurosurg 2018 Dec 8. Epub 2018 Dec 8.

Neurorestoration Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. Electronic address:

Large, broad-based basilar artery (BA) apex aneurysms involving multiple arterial origins are complex lesions commonly not amenable to direct clipping or endovascular management. BA proximal (Hunterian) occlusion with extracranial-to-intracranial bypass is a supported strategy if one or both posterior communicating arteries are small. Hunterian ligation risks sudden aneurysm thrombosis and thromboembolism in the perforator rich BA apex. Read More

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http://dx.doi.org/10.1016/j.wneu.2018.11.237DOI Listing
December 2018

Optical Coherence Tomography of Spontaneous Basilar Artery Dissection in a Patient With Acute Ischemic Stroke.

Front Neurol 2018 16;9:858. Epub 2018 Oct 16.

Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.

The diagnosis of intracranial arterial dissection (IAD) may be challenging and multimodal imaging techniques are often needed to confirm the diagnosis. Previous studies have based their criteria for diagnosis of IAD on conventional angiography, computed tomography, or magnetic resonance imaging. We report a case with acute ischemic stroke due to spontaneous basilar artery dissection in which intravascular optical coherence tomography (OCT) was used to show features of IAD. Read More

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http://dx.doi.org/10.3389/fneur.2018.00858DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6232774PMC
October 2018
1 Read

Endovascular rescue of vertebro-basilar thrombosis in cervical spine injury.

Spinal Cord Ser Cases 2018 9;4:101. Epub 2018 Nov 9.

3King Faisal Specialist Hospital and Research Center and Alfaisal University, Riyadh, Saudi Arabia.

Introduction: Vertebro-basilar thrombosis is often lethal. We report a post-traumatic case in which logistical issues were overcome to secure prompt endovascular intervention resulting in a favourable outcome.

Case Presentation: We report this case to highlight (i) the need, across the United Kingdom, for rapid access to 24/7 neurointerventional services and (ii) the fact that vertebral artery injury during C-spine trauma, while not uncommon, can rarely have catastrophic complications. Read More

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http://www.nature.com/articles/s41394-018-0132-1
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http://dx.doi.org/10.1038/s41394-018-0132-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6226425PMC
November 2018
5 Reads

[Surgical treatment of large and giant vertebrobasilar aneurysms manifested by brainstem compression symptoms].

Zh Vopr Neirokhir Im N N Burdenko 2018;82(4):32-37

Polenov Russian Research Institute of Neurosurgery, Branch of the Almazov National Medical Research Centre, St. Petersburg, Russia.

The study aim was to analyze the results of surgical treatment of vertebrobasilar (VB) aneurysms manifested by brainstem compression symptoms.

Material And Methods: The study included 8 patients operated on in the period between 2014 and 2017. All patients underwent intravascular intervention; two patients had open surgery at the second stage. Read More

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http://www.mediasphera.ru/issues/zhurnal-voprosy-nejrokhirur
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http://dx.doi.org/10.17116/neiro201882432DOI Listing
January 2018
11 Reads

Giant intracranial aneurysms of the posterior circulation and their relation to the brainstem: analysis of risk factors for neurological deficits.

J Neurosurg 2018 Aug 10:1-7. Epub 2018 Aug 10.

Department of Neurosurgery, Charité-Universitaetsmedizin Berlin.

OBJECTIVE Giant posterior circulation aneurysms (GPCirAs) usually cause substantial mass effect on the brainstem, which may lead to neurological deficits. So far, there has been no systematic investigation of factors associated with such deficits in GPCirA. The authors aim to examine the risk factors for cranial nerve deficit (CND), motor deficit, and disability in patients with GPCirA. Read More

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http://thejns.org/doi/10.3171/2018.4.JNS172343
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http://dx.doi.org/10.3171/2018.4.JNS172343DOI Listing
August 2018
4 Reads

Angioplasty and Stenting of Intracranial Arterial Stenosis in Perforator-Bearing Segments: A Comparison Between the Anterior and the Posterior Circulation.

Front Neurol 2018 9;9:533. Epub 2018 Jul 9.

Department of Neurology, Alfried Krupp Krankenhaus, Essen, Germany.

Subgroup analysis of the SAMMPRIS trial showed a higher rate of periprocedural perforator strokes with the Wingspan stent in the basilar artery in patients with symptomatic intracranial atherosclerotic stenosis (ICAS). It remains unclear whether angioplasty (PTA) alone or in combination with other stent types (PTAS) will yield similar results in perforator-bearing segments of the anterior and posterior circulation. We retrospectively analyzed the periprocedural complication rate, long term outcome and stroke etiology in 59 consecutive patients with ICAS of the middle cerebral artery (79 treatments) and 67 patients with ICAS of the intracranial vertebral and basilar artery (76 treatments) treated with PTA or PTAS from 2007 to 2015 in a high-volume neuro-interventional center. Read More

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http://dx.doi.org/10.3389/fneur.2018.00533DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6046376PMC
July 2018
14 Reads

Basilar Artery Thrombosis on Brain MRI.

Neurohospitalist 2018 Jul 25;8(3):NP3. Epub 2017 Sep 25.

Department of Neurology, Hazrat Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.1177/1941874417733218DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6022901PMC
July 2018
9 Reads

Beware the bright basilar artery: an early and specific CT sign of acute basilar artery thrombosis.

Intern Emerg Med 2018 Dec 3;13(8):1327-1328. Epub 2018 Jul 3.

Section of Interventional Neuroradiology, Division of Neuroradiology, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.

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http://link.springer.com/10.1007/s11739-018-1905-z
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http://dx.doi.org/10.1007/s11739-018-1905-zDOI Listing
December 2018
4 Reads

Facial Weakness and Ophthalmoplegia in a 4-Day-Old Infant.

Semin Pediatr Neurol 2018 07 2;26:63-66. Epub 2017 Apr 2.

Department of Pediatrics and Neurology, University of Iowa Stead Family Children's Hospital, Iowa City, IA.

We present a neonate with neurologic deficits recognized at 4 days of age. A male infant was born at term via emergency cesarian section due to failure to progress and fetal decelerations. He underwent therapeutic hypothermia for hypoxic ischemic encephalopathy. Read More

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http://dx.doi.org/10.1016/j.spen.2017.03.008DOI Listing
July 2018
12 Reads

A review of the diagnosis and management of vertebral basilar (posterior) circulation disease.

Surg Neurol Int 2018 24;9:106. Epub 2018 May 24.

Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, California, USA.

We have reviewed the English literature published in the last 70 years on Diseases of the Vertebral Basilar Circulation, or Posterior Circulation Disease (PCD). We have found that errors have been made in the conduct and interpretation of these studies that have led to incorrect approaches to the management of PCD. Because of the difficulty in evaluating the PC, the management of PCD has been incorrectly applied from anterior circulation disease (ACD) experience to PCD. Read More

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http://dx.doi.org/10.4103/sni.sni_373_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5991286PMC
May 2018
1 Read

LVIS Jr Device for Y-Stent-Assisted Coil Embolization of Wide-Neck Intracranial Aneurysms: A Multicenter Experience.

Interv Neurol 2018 Apr 3;7(5):271-283. Epub 2018 Apr 3.

Department of Neurology, Neurosurgery and Radiology, University of Iowa, Iowa, Iowa, USA.

Background And Purpose: Complex wide-neck intracranial aneurysms are challenging to treat. We report a multicenter experience using the LVIS Jr stent for "Y-stent"-assisted coiling embolization of wide-neck bifurcation aneurysms.

Methods: Seven centers provided retrospective data on patients who underwent Y-stenting. Read More

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http://dx.doi.org/10.1159/000487545DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5939862PMC
April 2018
3 Reads

Stent-assisted treatment of ruptured intracranial aneurysms in the acute phase: A single center experience.

eNeurologicalSci 2018 Mar 28;10:31-36. Epub 2018 Jan 28.

Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany.

Introduction: The purpose of this study was to analyze the results of patients with ruptured aneurysms who were treated with a specific microstent in the acute phase of subarachnoid hemorrhage.

Methods: Data from patients with acutely-ruptured intracranial aneurysm treated with the Neuroform stent in the period between 2003 and 2016 were retrospectively assessed, addressing aneurysm occlusion and clinical outcome with a focus on periprocedural complications.

Results: Twenty-nine consecutive patients with ruptured intracranial aneurysms were included in the analysis. Read More

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http://dx.doi.org/10.1016/j.ensci.2018.01.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5933999PMC
March 2018
6 Reads

Thrombectomy for late occlusion of high flow extracranial-intracranial saphenous vein bypass graft after 27 years of patency.

J Neurointerv Surg 2018 Nov 7;10(11):e27. Epub 2018 Apr 7.

Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

High flow extracranial-intracranial (EC-IC) bypass with a saphenous vein graft (SVG) has been used for more than 40 years in patients with giant aneurysms of the posterior circulation refractory to medical management, and has demonstrated high long term patency rates. We report the case of a patient treated with external carotid artery (ECA)-posterior cerebral artery SVG bypass in 1989 who presented 27 years later with paresthesias and confusion, and was found to have partial occlusion of her SVG bypass graft and a basilar occlusion. She was treated with mechanical thrombectomy of the basilar occlusion via the partially thrombosed graft, the first report of such a procedure through a high flow posterior circulation EC-IC SVG, resulting in improvement of the patient's neurologic examination. Read More

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http://jnis.bmj.com/lookup/doi/10.1136/neurintsurg-2017-0136
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http://dx.doi.org/10.1136/neurintsurg-2017-013670.repDOI Listing
November 2018
6 Reads

Late recanalization of basilar artery occlusion in a previously healthy 17-month-old child.

J Neurointerv Surg 2018 Jul 7;10(7):e17. Epub 2018 Apr 7.

Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.

Endovascular treatment of acute ischemic stroke in children is increasingly being reported, although the time window for intervention is unclear. We describe a previously healthy 17-month-old child who presented with vertebral artery thrombosis and cerebellar stroke requiring posterior fossa decompression. She later progressed to basilar artery thrombosis treated with mechanical thrombectomy 50 hours after clinical decline. Read More

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http://dx.doi.org/10.1136/neurintsurg-2017-013277.repDOI Listing
July 2018
3 Reads

Impact of stroke mechanism in acute basilar occlusion with reperfusion therapy.

Ann Clin Transl Neurol 2018 03 30;5(3):357-368. Epub 2018 Jan 30.

Department of Neurology Seoul National University Hospital Seoul South Korea.

Objective: We aimed to evaluate the impact of underlying mechanism of basilar artery (BA) occlusion on the outcomes after endovascular therapy (EVT) for reperfusion and the outcome factors associated with each mechanism, and to identify radiologic parameters enabling to distinguish the underlying mechanism.

Methods: From a registry database, 194 consecutive patients with acute BA occlusion who underwent EVT were analyzed. Stroke mechanism, classified into in situ atherosclerotic thrombosis (ISAT) and embolism, clot sign location profiles in pre-angiography magnetic resonance image (MRI), parameters of angiography and EVT, and reperfusion were assessed. Read More

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http://dx.doi.org/10.1002/acn3.536DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846447PMC
March 2018
3 Reads

Thrombectomy for late occlusion of high flow extracranial-intracranial saphenous vein bypass graft after 27 years of patency.

BMJ Case Rep 2018 Mar 8;2018. Epub 2018 Mar 8.

Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

High flow extracranial-intracranial (EC-IC) bypass with a saphenous vein graft (SVG) has been used for more than 40 years in patients with giant aneurysms of the posterior circulation refractory to medical management, and has demonstrated high long term patency rates. We report the case of a patient treated with external carotid artery (ECA)-posterior cerebral artery SVG bypass in 1989 who presented 27 years later with paresthesias and confusion, and was found to have partial occlusion of her SVG bypass graft and a basilar occlusion. She was treated with mechanical thrombectomy of the basilar occlusion via the partially thrombosed graft, the first report of such a procedure through a high flow posterior circulation EC-IC SVG, resulting in improvement of the patient's neurologic examination. Read More

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http://dx.doi.org/10.1136/bcr-2017-013670DOI Listing
March 2018
3 Reads

Botulinum toxin to improve vessel graft patency in cerebral revascularization surgery: report of 3 cases.

J Neurosurg 2018 Mar 2:1-7. Epub 2018 Mar 2.

Neurorestoration Center, Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles; and.

Surgical revascularization continues to play an important role in the management of complex intracranial aneurysms and ischemic cerebrovascular disease. Graft spasm is a common complication of bypass procedures and can result in ischemia or graft thrombosis. The authors here report on the first clinical use of botulinum toxin to prevent graft spasm following extracranial-intracranial (EC-IC) bypass. Read More

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http://dx.doi.org/10.3171/2017.9.JNS171292DOI Listing

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

PLoS One 2018 21;13(2):e0193051. Epub 2018 Feb 21.

Department of Neuroradiology, Ludwig-Maximilians University of Munich Hospitals, Grosshadern Campus, Munich, Germany.

Introduction: 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.

Methods: 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. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0193051PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5821367PMC
May 2018
2 Reads

Locked-in Syndrome and F-fluorodeoxyglucose-positron Emission Tomography/Computed Tomography: Observations from a Case of Basilar Artery Thrombosis.

Indian J Nucl Med 2018 Jan-Mar;33(1):65-67

Wolfson Molecular Imaging Centre, University of Manchester, Manchester, England, UK.

We report the case of a 59-year-old male patient suffering from locked-in syndrome (LIS) following basilar artery thrombosis despite an attempt of thrombolysis. Neurological examination showed quadriplegia and aphonia and a state of coma requiring mechanical ventilation was diagnosed. The use of F-fluorodeoxyglucose (F-FDG)-positron emission tomography (PET) allowed to detect a normal F-FDG uptake in the main cerebral cortical areas and a significant reduction of F-FDG uptake in both cerebellar hemispheres, compatible with a functional deafferentation, helping confirming the clinical suspicion of LIS. Read More

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http://dx.doi.org/10.4103/ijnm.IJNM_85_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5798105PMC
February 2018

Delayed cerebral thrombosis complicating pneumococcal meningitis: an autopsy study.

Ann Intensive Care 2018 Feb 9;8(1):20. Epub 2018 Feb 9.

Department of Neurology, Academic Medical Center, University of Amsterdam, Amsterdam Neuroscience, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.

Background: Delayed cerebral thrombosis (DCT) is a devastating cerebrovascular complication in patients with excellent initial recovery of pneumococcal meningitis. The aetiology is unknown, but direct bacterial invasion, activation of coagulation or post-infectious immunoglobulin deposition has been suggested.

Methods: We studied histopathology of 4 patients with pneumococcal meningitis complicated by DCT. Read More

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http://dx.doi.org/10.1186/s13613-018-0368-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5807251PMC
February 2018
2 Reads

Erythrocyte-Rich Thrombus Is Associated with Reduced Number of Maneuvers and Procedure Time in Patients with Acute Ischemic Stroke Undergoing Mechanical Thrombectomy.

Cerebrovasc Dis Extra 2018 15;8(1):39-49. Epub 2018 Jan 15.

Department of Neurosurgery, Ise Red Cross Hospital, Ise City, Japan.

Background: Only few studies have investigated the relationship between the histopathology of retrieved thrombi and clinical outcomes. This study aimed to evaluate thrombus composition and its association with clinical, laboratory, and neurointerventional findings in patients treated by mechanical thrombectomy due to acute large vessel occlusion.

Methods: At our institution, 79 patients were treated by mechanical thrombectomy using a stent retriever and/or aspiration catheter between August 2015 and August 2016. Read More

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http://dx.doi.org/10.1159/000486042DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5836222PMC
September 2018
7 Reads

Mechanical Thrombectomy in Basilar Artery Occlusion : Presence of Bilateral Posterior Communicating Arteries is a Predictor of Favorable Clinical Outcome.

Clin Neuroradiol 2017 Dec 19. Epub 2017 Dec 19.

Department of Neuroradiology, University Hospital Aachen, Aachen, Germany.

Background: Mechanical thrombectomy (MT) of basilar artery occlusions (BAO) is a subject of debate. We investigated the clinical outcome of MT in BAO and predictors of a favorable outcome.

Material And Methods: A total of 104 MTs of BAO (carried out between 2010 and 2016) were analyzed. Read More

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http://dx.doi.org/10.1007/s00062-017-0651-3DOI Listing
December 2017
17 Reads

Protective cerebrovascular effects of hydroxysafflor yellow A (HSYA) on ischemic stroke.

Eur J Pharmacol 2018 Jan 21;818:604-609. Epub 2017 Nov 21.

Department of Pharmacology, School of Pharmacy, Second Military Medical University, Shanghai 200433, China. Electronic address:

The purpose of the present work was designed to explore protective cerebrovascular effects of hydroxysafflor yellow A (HSYA), and provide preclinical efficacy and mechanism data for its possible application in patients with cerebral ischemia. The protective effect of HSYA on ischemic stroke was evaluated by infarct sizes and neurological scores in Sprague-Dawley (SD) rats with middle cerebral artery occlusion (MCAO). Cerebrovascular permeability was detected by Evans blue dye leakage in MCAO rats. Read More

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http://dx.doi.org/10.1016/j.ejphar.2017.11.033DOI Listing
January 2018
10 Reads

Dual Mechanical Thrombectomy for Recanalization of a Resistant Acute Posterior Circulation Stroke.

J Cerebrovasc Endovasc Neurosurg 2017 Jun 30;19(2):96-100. Epub 2017 Jun 30.

Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

A 71-year-old man with acute basilar artery occlusion was referred for endovascular treatment 6 hours after the onset of stroke with a Glasgow Coma Score of 3 and National Institutes of Health Stroke Scale of 27. A cerebral arteriogram revealed occlusion of the left vertebral artery proximally and thromboembolic occlusion of the basilar tip. Direct aspiration and mechanical thrombectomy with various stent retrievers failed to reconstitute arterial flow in the basilar artery. Read More

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http://dx.doi.org/10.7461/jcen.2017.19.2.96DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5678218PMC
June 2017
5 Reads

Thromboembolic complications during endovascular treatment of ruptured cerebral aneurysms.

Interv Neuroradiol 2018 Feb 10;24(1):29-39. Epub 2017 Nov 10.

4 Department of Neurosurgery, Shima Neurosurgical and Orthopedic Clinic, Kawasaki, Japan.

Background In cases of subarachnoid hemorrhage due to aneurysm rupture, the administration of an anticoagulant or antiplatelet agent involves the risk of rebleeding from the aneurysm. There is a possibility of inducing thromboembolic events during the endovascular embolization of ruptured cerebral aneurysms. Patients and methods From April 2006 to March 2017, we treated a total of 70 patients with ruptured cerebral aneurysms with an endovascular technique. Read More

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http://dx.doi.org/10.1177/1591019917739448DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5772543PMC
February 2018
8 Reads

Modification of hemodynamics in basilar artery aneurysm by the single and Y stent placement1.

Technol Health Care 2017 Oct;25(5):831-842

Department of Aerospace Engineering, Nagoya University, Nagoya, Japan.

Background: Stent placement can change the hemodynamics in basilar artery aneurysms. However, the effects of the stent placement can depend on the angle of vessel bifurcation.

Objective: The hemodynamics in and near the aneurysm are investigated for two angles of vessel bifurcation and two stent models. Read More

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http://dx.doi.org/10.3233/THC-160487DOI Listing
October 2017
2 Reads

Safe Readministration of Intravenous Thrombolysis in Recurrent Basilar Thrombosis.

J Stroke Cerebrovasc Dis 2018 Mar 31;27(3):e48-e49. Epub 2017 Oct 31.

North East Ohio Medical University, Rootstown, Ohio; Cleveland Clinic Akron General Medical Center, Akron, Ohio. Electronic address:

We report a patient who had recurrence of stroke in the basilar artery territory because of repeat thrombosis, and was administered intravenous recombinant tissue plasminogen activator (IV-rtPA) twice within a span of 3 weeks without any adverse events, with radiological evidence of successful thrombolysis. Because of minor and improving stroke symptoms with IV-rtPA, endovascular therapy was not performed and there was radiological evidence of recanalization with IV-rtPA alone. This report adds to the very limited literature on the topic demonstrating safe and successful use of repeat IV thrombolysis following a previous recent stroke. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10523057173055
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2017.09.066DOI Listing
March 2018
6 Reads

Late recanalization of basilar artery occlusion in a previously healthy 17-month-old child.

BMJ Case Rep 2017 Oct 13;2017. Epub 2017 Oct 13.

Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.

Endovascular treatment of acute ischemic stroke in children is increasingly being reported, although the time window for intervention is unclear. We describe a previously healthy 17-month-old child who presented with vertebral artery thrombosis and cerebellar stroke requiring posterior fossa decompression. She later progressed to basilar artery thrombosis treated with mechanical thrombectomy 50 hours after clinical decline. Read More

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http://dx.doi.org/10.1136/neurintsurg-2017-013277DOI Listing
October 2017
1 Read

Meningovascular neurosyphilis with basilar artery thrombosis in HIV patient.

J Infect Public Health 2018 May - Jun;11(3):439-441. Epub 2017 Oct 6.

Radiology Department, Specialty Hospital, National Medical Center "La Raza", IMSS, Ciudad de Mexico, Mexico.

Currently, neurosyphilis is an uncommon disease and may occur at any stage of syphilis. Co-infection of syphilis with HIV can affect the clinical course. We report a case of meningovascular neurosyphilis in a patient with HIV in whom basilar artery thrombosis and reactive VDRL in CSF were detected. Read More

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http://dx.doi.org/10.1016/j.jiph.2017.09.009DOI Listing
November 2018
4 Reads

Endovascular treatment for acute basilar thrombosis via a transradial approach: Initial experience and future considerations.

Interv Neuroradiol 2018 Feb 28;24(1):64-69. Epub 2017 Sep 28.

1 Department of Radiology, Hospital of the 14640 University of Pennsylvania, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, PA, USA.

Acute basilar artery occlusion (BAO) secondary to emergent large vessel occlusion (ELVO) has an extremely poor natural history, with a reported mortality rate up to 95%. Mechanical thrombectomy in the setting of ELVO is generally performed via a transfemoral approach. However, radial access is increasingly being utilized as an alternative. Read More

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http://dx.doi.org/10.1177/1591019917733709DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5772535PMC
February 2018
2 Reads

Dolichoectasia of Vertebrobasilar Arteries as a Cause of Hydrocephalus and Ischemic Cerebral Stroke.

Am J Forensic Med Pathol 2017 Dec;38(4):359-361

From the Departments of *Forensic Medicine and †Radiology, Faculty of Medicine, University of Nis; and ‡Private Hospital "Sava Surgery," Nis, Serbia.

Introduction: Dolichoectasia of vertebrobasilar artery is a rare vasculopathy, which is characterized by ectasia, elongation, and tortuosity of the basilar artery.

Case Description: A 85-year-old man was referred to the Clinic of Neurology with sudden-onset coma. A brain computed tomography scan showed remarkable fusiform dilatation with elongation of basilar artery, with compressive effect on brain stem. Read More

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http://dx.doi.org/10.1097/PAF.0000000000000348DOI Listing
December 2017
16 Reads

Tirofiban facilitates the reperfusion process during endovascular thrombectomy in ICAS.

Exp Ther Med 2017 Oct 31;14(4):3314-3318. Epub 2017 Jul 31.

Department of Neurology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, P.R. China.

The aim of the present study was to assess the use of tirofiban injections for rescue therapy following artery reocclusion due to intra-luminal thrombosis during endovascular thrombectomy in patients with acute ischemic stroke (AIS). A total of seven cases of patients treated with adjunctive tirofiban injections following failed endovascular thrombectomy due to instant intra-luminal thrombosis were retrospectively assessed. A Solitaire stent was used as the primary thrombectomy device in all patients. Read More

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http://dx.doi.org/10.3892/etm.2017.4856DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5585762PMC
October 2017
18 Reads

[Stroke due to acute occlusion of the basilar artery : Diagnosis and treatment].

Authors:
S Nagel

Med Klin Intensivmed Notfmed 2017 Nov 13;112(8):679-686. Epub 2017 Sep 13.

Neurologische Klinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.

Acute occlusion of the basilar artery is a rare and, if left untreated, severe neurovascular condition with a high mortality. The clinical presentation is often atypical and hence diagnosis may be delayed. Because of the devastating natural course, recanalization strategies were often more aggressive than in patients with occlusions in the anterior circulation. Read More

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http://dx.doi.org/10.1007/s00063-017-0347-0DOI Listing
November 2017
1 Read

Basilar artery thrombosis caused by vertebral dissection secondary to brachial plexus block.

Neurologia 2017 Aug 28. Epub 2017 Aug 28.

Servicio de Neurología, Hospital Clínic de Barcelona, Barcelona, España. Electronic address:

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http://dx.doi.org/10.1016/j.nrl.2017.06.007DOI Listing
August 2017
4 Reads

Staged Trapping of Traumatic Basilar Trunk Pseudoaneurysm: Case Report and Review of Literature.

World Neurosurg 2017 Dec 1;108:991.e7-991.e12. Epub 2017 Sep 1.

Department of Neurosurgery, Saint Louis University, Saint Louis, Missouri, USA. Electronic address:

Background: Traumatic intracranial aneurysms (TICAs) of the posterior circulation in the pediatric populations are rare. Only a few reports in the literature document basilar artery TICA in the pediatric population. These cases were typically associated with a clival fracture and commonly diagnosed weeks to months after trauma. Read More

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http://dx.doi.org/10.1016/j.wneu.2017.08.144DOI Listing
December 2017
12 Reads

Apixaban Enhances Vasodilatation Mediated by Protease-Activated Receptor 2 in Isolated Rat Arteries.

Front Pharmacol 2017 18;8:480. Epub 2017 Jul 18.

Pharmacology Section, Department of Biomedical and Biotechnological Sciences, University of CataniaCatania, Italy.

Apixaban (APX) is a direct inhibitor of factor X (FXa) approved for prophylaxis and treatment of deep venous thrombosis and atrial fibrillation. Because FXa activates protease-activated receptor 2 (PAR-2) in endothelium and vascular smooth muscle, inhibition of FXa by APX may affect vasomotor function. The effect of APX was assessed , by wire myography, in rat mesenteric resistance arteries (MRAs) and basilar arteries challenged with vasoconstrictors [phenylephrine (PE); 5-hydroxytryptamine (5-HT)], vasodilators [acetylcholine (ACh); sodium nitroprusside (SNP)] or with the PAR-2 peptide agonist SLIGRL. Read More

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http://dx.doi.org/10.3389/fphar.2017.00480DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513931PMC
July 2017
10 Reads

Delayed Endovascular Stenting for Severe Vertebral Artery Stenosis with Precarious Thrombosis.

Cureus 2017 May 26;9(5):e1277. Epub 2017 May 26.

Department of Radiology, Baylor University Medical Center.

A significant but less recognized cause of ischemic stroke and transient ischemic attack (TIA) is atherosclerosis of the vertebrobasilar system, which accounts for 20% of ischemic strokes. Pathology of the vertebrobasilar system can present significant challenges in determining the course of treatment. Due to the complexity of the vertebrobasilar system, there is slight disagreement about how to approach patients with atherosclerotic pathology of the posterior circulation. Read More

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http://dx.doi.org/10.7759/cureus.1277DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5484603PMC
May 2017
15 Reads

Cross-circulation thrombectomy with use of a stent retriever: A case report.

Interv Neuroradiol 2017 Aug 8;23(4):422-426. Epub 2017 May 8.

Medical College of Wisconsin, Milwaukee, WI, USA.

Introduction The efficacy of the endovascular treatment of acute ischemic stroke has been substantiated by several recent randomized clinical trials. While intra-arterial therapy has significantly evolved in recent years, anatomic cerebrovascular variants and disease burden can present challenges to timely recanalization. We present the first reported case of anterior-to-posterior mechanical clot retrieval with use of a stent retriever. Read More

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http://dx.doi.org/10.1177/1591019917706191DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5684909PMC
August 2017
10 Reads

Critical care in acute ischemic stroke.

Handb Clin Neurol 2017 ;140:153-176

Stroke Program, University of Michigan, Ann Arbor, MI, USA.

Most ischemic strokes are managed on the ward or on designated stroke units. A significant proportion of patients with ischemic stroke require more specialized care. Several studies have shown improved outcomes for patients with acute ischemic stroke when neurocritical care services are available. Read More

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http://dx.doi.org/10.1016/B978-0-444-63600-3.00010-6DOI Listing
March 2017
10 Reads

Aspiration thrombectomy in clinical routine interventional stroke treatment : Is this the end of the stent retriever era?

Clin Neuroradiol 2018 Jun 12;28(2):217-224. Epub 2017 Jan 12.

Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.

Purpose: The aim of our study was the technical evaluation of a first pass approach of primary thrombus aspiration (AST) in patients with emergency large intracerebral vessel occlusions (ELVO) under routine clinical conditions.

Materials And Methods: We collected procedural and clinical data of 104 patients who underwent mechanical thrombectomy due to ELVO between June 2014 and January 2016 with intentional first-line thrombus aspiration. Procedures were conducted due to occlusions of the distal internal carotid artery, middle cerebral artery, anterior cerebral artery, basilar artery and posterior cerebral artery and were performed with the patient under either conscious sedation or general anesthesia. Read More

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http://dx.doi.org/10.1007/s00062-016-0555-7DOI Listing
June 2018
4 Reads

Outcome Evaluation of Acute Ischemic Stroke Patients Treated with Endovascular Thrombectomy: A Single-Institution Experience in the Era of Randomized Controlled Trials.

World Neurosurg 2017 Mar 23;99:593-598. Epub 2016 Dec 23.

Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Neurosurgery, Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Faculty of Applied Sciences and Engineering, University of Toronto, Toronto, Ontario, Canada. Electronic address:

Background: Endovascular thrombectomy is an effective procedure to treat selected ischemic strokes, as shown in recent randomized controlled trials (RCTs). The generalizability of these trial data to real-world settings, however, is unknown. The aim of this study was to examine our single-center experience with endovascular thrombectomy for acute ischemic strokes and perform a comparative outcome analysis to the most recent RCTs. Read More

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http://dx.doi.org/10.1016/j.wneu.2016.12.054DOI Listing
March 2017
8 Reads

Mechanical thrombectomy for basilar artery thrombosis: a comparison of outcomes with anterior circulation occlusions.

J Neurointerv Surg 2017 Dec 20;9(12):1173-1178. Epub 2016 Dec 20.

La Paz University Hospital, IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain.

Background And Purpose: The benefits of mechanical thrombectomy (MT) in basilar artery occlusions (BAO) have not been explored in recent clinical trials. We compared outcomes and procedural complications of MT in BAO with anterior circulation occlusions.

Methods: Data from the Madrid Stroke Network multicenter prospective registry were analyzed, including baseline characteristics, procedure times, procedural complications, symptomatic intracranial hemorrhage (SICH), modified Rankin Scale (mRS), and mortality at 3 months. Read More

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http://dx.doi.org/10.1136/neurintsurg-2016-012797DOI Listing
December 2017
46 Reads

Where did the clot go? An unusual complication of mechanical thrombectomy caused by malignancy related subclavian steal phenomenon in a patient with acute basilar artery occlusion.

J Neurointerv Surg 2017 Jun 31;9(6):e22. Epub 2016 Oct 31.

Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada.

Subclavian steal is a relatively common vascular phenomenon usually caused by atherosclerotic disease. While symptoms are rare, arm claudication of the ipsilateral limb is most common, with paroxysmal symptoms of vertebrobasilar insufficiency (often exercise induced) being relatively uncommon. Here we present a case of brachial artery embolism during mechanical thrombectomy for basilar artery thrombosis, secondary to subclavian steal phenomenon. Read More

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http://dx.doi.org/10.1136/neurintsurg-2016-012665.repDOI Listing
June 2017
12 Reads

A rare case of absent left common carotid artery with bovine origin of the left external carotid artery.

J Neurointerv Surg 2017 May 8;9(5):e20. Epub 2016 Oct 8.

Department of Neurosurgery, Sir Ganga Ram Hospital, New Delhi, India.

A 22-year-old man had cerebral venous sinus thrombosis and his angiogram incidentally revealed an absent left common carotid artery with bovine origin of the left external carotid artery. There was also an associated low bifurcation of the right common carotid artery and basilar artery fenestration. The absence of a common carotid artery is a very rare angiographic finding, and an association with a bovine origin of the left external carotid artery has not been reported previously in the literature. Read More

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http://dx.doi.org/10.1136/neurintsurg-2016-012540.repDOI Listing
May 2017
10 Reads
1 Citation

Where did the clot go? An unusual complication of mechanical thrombectomy caused by malignancy related subclavian steal phenomenon in a patient with acute basilar artery occlusion.

BMJ Case Rep 2016 Oct 25;2016. Epub 2016 Oct 25.

Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada.

Subclavian steal is a relatively common vascular phenomenon usually caused by atherosclerotic disease. While symptoms are rare, arm claudication of the ipsilateral limb is most common, with paroxysmal symptoms of vertebrobasilar insufficiency (often exercise induced) being relatively uncommon. Here we present a case of brachial artery embolism during mechanical thrombectomy for basilar artery thrombosis, secondary to subclavian steal phenomenon. Read More

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http://dx.doi.org/10.1136/bcr-2016-012665DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5093838PMC
October 2016
11 Reads

Successful recanalization in acute basilar artery occlusion treated with endovascular therapy is independent of thrombus length.

J Neurointerv Surg 2017 Nov 27;9(11):1047-1052. Epub 2016 Oct 27.

Department of Radiology and Neuroradiology, University Hospital of Schleswig-Holstein, Kiel, Germany.

Background And Purpose: As previously demonstrated, the recanalization rate and clinical outcome in patients with anterior circulation stroke treated with IV thrombolysis (IVT) depend on clot characteristics such as thrombus length and thrombus density. In patients with basilar artery occlusion (BAO) treated with IVT, the recanalization rate has also been shown to depend on thrombus length, although no cut-off value beyond which recanalization would seem impossible has been determined. We aim to evaluate the correlation of clot characteristics with recanalization rate and outcome in patients with BAO treated with endovascular therapy (EVT). Read More

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http://dx.doi.org/10.1136/neurintsurg-2016-012634DOI Listing
November 2017
9 Reads

Histological Examination of Trousseau Syndrome-Related Thrombus Retrieved Through Acute Endovascular Thrombectomy: Report of 2 Cases.

J Stroke Cerebrovasc Dis 2016 Dec 6;25(12):e227-e230. Epub 2016 Oct 6.

Department of Neurosurgery, Kurashiki Central Hospital, Kyoto, Japan.

The mechanism of thrombus formation in Trousseau syndrome remains unclear. The purpose of this study was to investigate specific pathological findings of the thrombi in Trousseau syndrome. The authors report on 2 cases of thrombi in Trousseau syndrome from large cerebral vessels removed by endovascular therapy and compared with thrombi in atherosclerosis or cardiac embolism. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2016.08.041DOI Listing
December 2016
11 Reads

[Injuries to blood vessels near the heart caused by central venous catheters].

Anaesthesist 2016 Nov;65(11):866-871

Bodensee Medizin Campus, Klinik für Anästhesie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Röntgenstraße 2, 88048, Friedrichshafen, Deutschland.

Injuries to blood vessels near the heart can quickly become life-threatening and include arterial injuries during central venous puncture, which can lead to hemorrhagic shock. We report 6 patients in whom injury to the subclavian artery and vein led to life-threatening complications. Central venous catheters are associated with a multitude of risks, such as venous thrombosis, air embolism, systemic or local infections, paresthesia, hemothorax, pneumothorax, and cervical hematoma, which are not always immediately discernible. Read More

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http://dx.doi.org/10.1007/s00101-016-0226-8DOI Listing
November 2016
9 Reads