Vertebrobasilar revascularization rates and outcomes in the MERCI and multi-MERCI trials

J Stroke Cerebrovasc Dis. Mar-Apr 2008;17(2):55-7. doi: 10.1016/j.jstrokecerebrovasdis.2007.11.003.

Abstract

Objective: Mortality of 40% to 86% and good outcomes in only 13% to 21% of patients beg for treatment options for basilar occlusion. This study determined outcomes of patients with vertebrobasilar occlusion treated with mechanical embolus removal in cerebral ischemia (MERCI) retriever mechanical thrombectomy.

Methods: Patients with vertebrobasilar occlusion in the MERCI and Multi-MERCI trials received treatment up to 8 hours after symptom onset. Recanalization was determined after retriever use and adjunctive therapy. Mortality and good outcomes, modified Rankin scale score 0-3, were determined at 90 days in patients who were recanalized and not recanalized.

Results: Recanalization occurred in 21 of 27 (78%) patients. Mortality was 44% and good outcomes were seen in 41%. Patients with recanalization tended to have better outcomes than those without.

Conclusions: Outcomes in patients with vertebrobasilar occlusions treated with the MERCI retriever compared favorably with natural history reports and tended to be better in those patients with recanalization.

Publication types

  • Meta-Analysis

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Equipment Design
  • Female
  • Fibrinolytic Agents / administration & dosage*
  • Humans
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Multicenter Studies as Topic
  • Randomized Controlled Trials as Topic
  • Recovery of Function
  • Severity of Illness Index
  • Stroke / drug therapy
  • Stroke / etiology
  • Stroke / mortality
  • Stroke / physiopathology
  • Stroke / surgery*
  • Thrombectomy / instrumentation*
  • Thrombolytic Therapy*
  • Time Factors
  • Tissue Plasminogen Activator / administration & dosage*
  • Treatment Outcome
  • Vascular Patency*
  • Vertebrobasilar Insufficiency / complications
  • Vertebrobasilar Insufficiency / drug therapy
  • Vertebrobasilar Insufficiency / mortality
  • Vertebrobasilar Insufficiency / physiopathology
  • Vertebrobasilar Insufficiency / surgery*

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator