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Proceedings SNO “Percorsi clinici in Neuroscienze”

Figure 2. Selective in- A B
jections of the left verte-
bral artery in AP projec-
tion (A-B) showing the
aspiration-catheter
against the proximal
end of the thrombus.
Post-aspiration angio-
grams in AP e LL pro-
jections (C-D) exhibit a
high-grade stenosis of
mid BA.

C D

lation strokes . Emergency thrombectomy results in Administration of glycoprotein IIb/IIIa inhibitors is
(1)
better recanalisation rates and clinical outcomes com- required to maintain the patency of the stent, but care
pared to intravenous thrombolysis (BASILAR reg- should be taken regarding the choice of the type of
(2)
istry) . drugs and doses. In this case we have preferred to use
Aspiration thrombectomy, using a large-bore aspira- Tirofiban over Abciximab for the lower risk of symp-
tion catheter system, is a first-line recanalization tomatic intracranial haemorrhage, as reported in a re-
(6)
method for BA occlusion, leading to a lower number cent meta-analysis .
of passes than stent retriever and lower frequency of Among patients with acute BA occlusion, baseline
sub-arachnoid haemorrhage . However, failure of NIHSS score, ASPECTS score and occlusion site are
(3)
reperfusion is reported in 18-50% of cases, due to the independent factors associated with clinical out-
(7)
high incidence of severe atherosclerotic stenosis in comes .
(4)
the posterior intracranial circulation . Our case demonstrates that early endovascular thera-
In this setting, acute stenting following thrombectomy py should be considered as an effective strategy for
seems to improve functional outcome when compare treatment of acute BA occlusion with severe symp-
to thrombectomy alone (ANGEL-ACT Registry) . toms. Thrombectomy combined with angioplasty and
(5)

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