{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T22:48:40Z","timestamp":1776725320444,"version":"3.51.2"},"reference-count":33,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2012,5]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The treatment of acute intracranial vertebrobasilar artery occlusion (VBO) has been described but often with poor results. The authors of this study set out to evaluate their institution's outcomes following multimodal treatment of VBO.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>They retrospectively reviewed their endovascular database for all patients treated for acute intracranial VBO between December 2004 and June 2010. Twenty-four patients were identified. Two patients were excluded from evaluation\u2014one because of incomplete medical records and one because the etiology was basilar stenosis and not stroke. Occlusion location, hypercoagulable causes, time to endovascular treatment, time to revascularization, comorbidities, devices used, procedural anticoagulation, and outcomes were analyzed.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Among the 22 eligible study patients, the mean National Institutes of Health Stroke Scale (NIHSS) score at presentation was 15.3. The mean time from presentation to initiation of the endovascular procedure was 4.77 hours. The mean time for recanalization from the start of angiography was 1.63 hours. In 16 patients (73%), revascularization was successful (Thrombolysis in Myocardial Infarction [TIMI] score of 2 or 3). Thirteen (59%) of the 22 patients were discharged to home or a rehabilitation facility. One patient was transferred to a chronic care facility. The overall survival rate was 64%. The average NIHSS score for the 14 surviving patients at discharge was 3.9. At the follow-up (average 14.5 months, range 1\u201358 months), 10 patients (71%) had achieved good outcomes (modified Rankin Scale [mRS] score \u2264 2) and 4 (29%) had poor outcomes (mRS Score 3\u20136<jats:italic>).<\/jats:italic><\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Published case series have historically shown poor outcomes and high mortality rates in association with the treatment of acute VBO, prompting surgeons to be less aggressive in the treatment of this disease than they might be otherwise. Data in this series show that the revascularization of posterior circulation occlusions is feasible and that good outcomes and lower mortality rates with newer endovascular technologies are possible, and thus more prompt and aggressive treatment of this disease may be warranted.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2012.1.jns11997","type":"journal-article","created":{"date-parts":[[2012,2,3]],"date-time":"2012-02-03T15:04:50Z","timestamp":1328281490000},"page":"952-960","source":"Crossref","is-referenced-by-count":3,"title":["Treatment and outcomes of acute intracranial vertebrobasilar artery occlusion: one institution's experience"],"prefix":"10.3171","volume":"116","author":[{"given":"Sharon","family":"Webb","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Department of Neurosurgery, Millard Fillmore Gates Circle Hospital\u2013Kaleida Health, Buffalo, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parham","family":"Yashar","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Department of Neurosurgery, Millard Fillmore Gates Circle Hospital\u2013Kaleida Health, Buffalo, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Kan","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Department of Neurosurgery, Millard Fillmore Gates Circle Hospital\u2013Kaleida Health, Buffalo, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adnan H.","family":"Siddiqui","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Radiology, School of Medicine and Biomedical Sciences;"},{"name":"Toshiba Stroke Research Center, University at Buffalo, State University of New York; and"},{"name":"Department of Neurosurgery, Millard Fillmore Gates Circle Hospital\u2013Kaleida Health, Buffalo, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. Nelson","family":"Hopkins","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Radiology, School of Medicine and Biomedical Sciences;"},{"name":"Toshiba Stroke Research Center, University at Buffalo, State University of New York; and"},{"name":"Department of Neurosurgery, Millard Fillmore Gates Circle Hospital\u2013Kaleida Health, Buffalo, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elad I.","family":"Levy","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Radiology, School of Medicine and Biomedical Sciences;"},{"name":"Toshiba Stroke Research Center, University at Buffalo, State University of New York; and"},{"name":"Department of Neurosurgery, Millard Fillmore Gates Circle Hospital\u2013Kaleida Health, Buffalo, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-jns11997","series-title":"Stroke","first-page":"383","article-title":"Basilar artery occlusion: clinical and radiological correlation","volume":"8","author":"Archer","year":"1977"},{"key":"b2-jns11997","series-title":"J Neurol Neurosurg Psychiatry","first-page":"857","article-title":"Clinical and radiological predictors of recanalisation and outcome of 40 patients with acute basilar artery occlusion treated with intra-arterial thrombolysis","volume":"75","author":"Arnold","year":"2004"},{"key":"b3-jns11997","series-title":"AJNR Am J Neuroradiol","first-page":"255","article-title":"Intraarterial thrombolysis in vertebrobasilar occlusion","volume":"17","author":"Becker","year":"1996"},{"key":"b4-jns11997","series-title":"Cerebrovasc Dis","first-page":"183","article-title":"Long-term outcome after local intra-arterial fibrinolysis of basilar artery thrombosis","volume":"10","author":"Berg-Dammer","year":"2000"},{"key":"b5-jns11997","series-title":"Stroke","first-page":"875","article-title":"Thrombolytic therapy of acute basilar artery occlusion. Variables affecting recanalization and outcome","volume":"27","author":"Brandt","year":"1996"},{"key":"b6-jns11997","series-title":"Stroke","first-page":"847","article-title":"Stent placement in acute cerebral artery occlusion: use of a self-expandable intracranial stent for acute stroke treatment","volume":"40","author":"Brekenfeld","year":"2009"},{"key":"b7-jns11997","series-title":"Acta Radiol Suppl","first-page":"38","article-title":"Acute vertebral-basilar thrombosis. Angiologic-clinical comparison and therapeutic implications","volume":"369","author":"Br\u00fcckmann","year":"1986"},{"key":"b8-jns11997","series-title":"AJNR Am J Neuroradiol","first-page":"282","article-title":"Thromboaspiration in the basilar artery: report of two cases","volume":"23","author":"Chapot","year":"2002"},{"key":"b9-jns11997","series-title":"AJNR Am J Neuroradiol","first-page":"1557","article-title":"Collateral circulation and outcome after basilar artery thrombolysis","volume":"19","author":"Cross","year":"1998"},{"key":"b10-jns11997","series-title":"AJNR Am J Neuroradiol","first-page":"1221","article-title":"Relationship between clot location and outcome after basilar artery thrombolysis","volume":"18","author":"Cross","year":"1997"},{"key":"b11-jns11997","series-title":"Stroke","first-page":"1160","article-title":"Aggressive therapy with intravenous abciximab and intra-arterial rtPA and additional PTA\/stenting improves clinical outcome in acute vertebrobasilar occlusion: combined local fibrinolysis and intravenous abciximab in acute vertebrobasilar stroke treatment (FAST): results of a multicenter study","volume":"36","author":"Eckert","year":"2005"},{"key":"b12-jns11997","series-title":"Cerebrovasc Dis","first-page":"42","article-title":"Endovascular therapy of acute vertebrobasilar occlusion: early treatment onset as the most important factor","volume":"14","author":"Eckert","year":"2002"},{"key":"b13-jns11997","series-title":"J Stroke Cerebrovasc Dis","first-page":"22","article-title":"Efficacy of intraarterial thrombolysis of basilar artery stroke","volume":"8","author":"Egan","year":"1999"},{"key":"b14-jns11997","series-title":"Surg Neurol","first-page":"423","article-title":"Retrospective analysis of neurological outcome after intra-arterial thrombolysis in basilar artery occlusion","volume":"60","author":"Ezaki","year":"2003"},{"key":"b15-jns11997","series-title":"JAMA","first-page":"2003","article-title":"Intra-arterial prourokinase for acute ischemic stroke. The PROACT II study: a randomized controlled trial Prolyse in Acute Cerebral Thromboembolism","volume":"282","author":"Furlan","year":"1999"},{"key":"b16-jns11997","series-title":"N Engl J Med","first-page":"1317","article-title":"Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke","volume":"359","author":"Hacke","year":"2008"},{"key":"b17-jns11997","series-title":"Stroke","first-page":"1216","article-title":"Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease","volume":"19","author":"Hacke","year":"1988"},{"key":"b18-jns11997","series-title":"Neuroradiology","first-page":"361","article-title":"Endovascular recanalization of acute intracranial vertebrobasilar artery occlusion using local fibrinolysis and additional balloon angioplasty","volume":"52","author":"Kashiwagi","year":"2010"},{"key":"b19-jns11997","series-title":"AJNR Am J Neuroradiol","first-page":"816","article-title":"Self-expanding stents for recanalization of acute cerebrovascular occlusions","volume":"28","author":"Levy","year":"2007"},{"key":"b20-jns11997","series-title":"Stroke","first-page":"922","article-title":"Therapy of basilar artery occlusion: a systematic analysis comparing intra-arterial and intravenous thrombolysis","volume":"37","author":"Lindsberg","year":"2006"},{"key":"b21-jns11997","series-title":"Neurosurgery","first-page":"860","article-title":"Safety, effectiveness, and practicality of endovascular therapy within the first 3 hours of acute ischemic stroke onset","volume":"65","author":"Mathews","year":"2009"},{"key":"b22-jns11997","series-title":"J Neurosurg","first-page":"557","article-title":"Use of a vascular reconstruction device to salvage acute ischemic occlusions refractory to traditional endovascular recanalization methods. Clinical article","volume":"112","author":"Mocco","year":"2010"},{"key":"b23-jns11997","series-title":"World Neurosurg","first-page":"455","article-title":"Prospective acute ischemic stroke outcomes after endovascular therapy: a real-world experience","volume":"74","author":"Natarajan","year":"2010"},{"key":"b24-jns11997","series-title":"Stroke","first-page":"3269","article-title":"Safety and effectiveness of endovascular therapy after 8 hours of acute ischemic stroke onset and wake-up strokes","volume":"40","author":"Natarajan","year":"2009"},{"key":"b25-jns11997","series-title":"N Engl J Med","first-page":"1581","article-title":"Tissue plasminogen activator for acute ischemic stroke","volume":"333","author":"National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group","year":"1995"},{"key":"b26-jns11997","series-title":"Cerebrovasc Dis","first-page":"614","article-title":"Basilar artery occlusion treated with mechanical thrombectomy beyond eight hours with successful recanalization and good functional outcomes","volume":"27","author":"Noufal","year":"2009"},{"key":"b27-jns11997","series-title":"Neurosurgery","first-page":"1282","article-title":"Angioplasty of intracranial occlusion resistant to thrombolysis in acute ischemic stroke","volume":"48","author":"Ringer","year":"2001"},{"key":"b28-jns11997","series-title":"Neuroradiology","first-page":"273","article-title":"Combined interventional stroke therapy using intracranial stent and local intraarterial thrombolysis (LIT)","volume":"53","author":"Seifert","year":"2011"},{"key":"b29-jns11997","series-title":"Cerebrovasc Dis","first-page":"214","article-title":"Long-term follow-up of patients after intraarterial thrombolytic therapy of acute vertebrobasilar artery occlusion","volume":"12","author":"Sliwka","year":"2001"},{"key":"b30-jns11997","series-title":"Stroke","first-page":"1205","article-title":"Mechanical thrombectomy for acute ischemic stroke: final results of the Multi MERCI trial","volume":"39","author":"Smith","year":"2008"},{"key":"b31-jns11997","series-title":"AJNR Am J Neuroradiol","first-page":"875","article-title":"Mechanical thrombectomy for acute stroke","volume":"26","author":"Versnick","year":"2005"},{"key":"b32-jns11997","series-title":"J Vasc Interv Radiol","first-page":"1359","article-title":"Intraarterial thrombolysis and stent placement for acute basilar artery occlusion","volume":"21","author":"Yu","year":"2010"},{"key":"b33-jns11997","series-title":"Stroke","first-page":"2392","article-title":"Interventional acute ischemic stroke therapy with intracranial self-expanding stent","volume":"39","author":"Zaidat","year":"2008"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/116\/5\/article-p952.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/116\/5\/article-p952.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/116\/5\/article-p952.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T01:01:56Z","timestamp":1679878916000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/116\/5\/article-p952.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2012,5]]},"references-count":33,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2012.1.jns11997","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,5]]}}}