Open AccessNeuroendovascular Management of Acute Ischemic Basilar Strokes: 2-Dimensional Operative Video
Author(s) -
Guilherme Porto,
Mithun G. Sattur,
Sami Al Kasab,
Alejandro M Spiotta
Publication year - 2021
Publication title -
operative neurosurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.791
H-Index - 21
eISSN - 2332-4260
pISSN - 2332-4252
DOI - 10.1093/ons/opab180
Subject(s) - medicine , basilar artery , icad , stroke (engine) , neurosurgery , angioplasty , stenosis , radiology , balloon , surgery , mechanical engineering , biochemistry , chemistry , engineering , gene
Basilar artery occlusions (BAOs) are devastating ischemic strokes that account for 1% of all strokes with high morbidity and mortality; however, neuroendovascular techniques such as ADAPT have recently revolutionized the clinical outcomes of these patients.1-3 Common underlying pathology in patients with BAO include intracranial atherosclerotic disease (ICAD) as well as thromboembolic origin.4 Basilar artery ICAD in a setting of acute stroke portends a poor prognosis and post-thrombectomy residual critical flow limiting stenosis treatment options, including balloon angioplasty with or without stent placement.5-7 We present a video illustration of neuroendovascular technique and challenges encountered when managing this pathology. Image at 5:42 reprinted with permission from Alawieh et al, Lessons learned over more than 500 stroke thrombectomies using ADAPT with increasing aspiration catheter size, Neurosurgery, 86(1), 2020, pp. 61-70, with permission from the Congress of Neurological Surgeons.1.