Book review

https://doi.org/10.20471/acc.2023.62.03.20

Basilar Artery Reocclusion within 24 Hours after Mechanical Thrombectomy Successfully Treated with New Intervention

Goran Knezović ; Department of Neurology, Faculty of Medicine in Novi Sad, University of Novi Sad, Novi Sad, Serbia; Department of Neurology, University Clinical Center of Vojvodina, Novi Sad, Serbia
Jelena Milojković ; Department of Neurology, University Clinical Center of Vojvodina, Novi Sad, Serbia
Dmitar Vlahović ; Department of Neurology, Faculty of Medicine in Novi Sad, University of Novi Sad, Novi Sad, Serbia; Department of Neurology, University Clinical Center of Vojvodina, Novi Sad, Serbia
Aleksandra Lučić-Prokin ; Department of Neurology, Faculty of Medicine in Novi Sad, University of Novi Sad, Novi Sad, Serbia; Department of Neurology, University Clinical Center of Vojvodina, Novi Sad, Serbia
Timea Kokai-Zekić ; Department of Neurology, University Clinical Center of Vojvodina, Novi Sad, Serbia
Slobodan Torbica ; Department of Radiology, Faculty of Medicine in Novi Sad, University of Novi Sad, Novi Sad, Serbia; Department of Radiology, University Clinical Center of Vojvodina, Novi Sad, Serbia
Vedran Žigić ; Department of Radiology, University Clinical Center of Vojvodina, Novi Sad, Serbia
Vladimir Knezović ; Institute of Cardiovascular Diseases, Novi Sad, Vojvodina, Serbia
Svetlana Simić ; Department of Neurology, Faculty of Medicine in Novi Sad, University of Novi Sad, Novi Sad, Serbia; Department of Neurology, University Clinical Center of Vojvodina, Novi Sad, Serbia
Željko Živanović orcid.org/0000-0001-5414-8623 ; Department of Neurology, Faculty of Medicine in Novi Sad, University of Novi Sad, Novi Sad, Serbia; Department of Neurology, University Clinical Center of Vojvodina, Novi Sad, Serbia *

* Corresponding author.

Abstract

Acute basilar artery occlusion (BAO) may cause ischemia in the region of brainstem,
parts of the thalamus, occipital lobes, and cerebellum, resulting in severe disability or mortality
rate above 70%. Recurrent BAO has been described in only a small number of cases. We present
a case of repeated mechanical thrombectomy (MT) for the tip of basilar artery (BA) reocclusion
within 24 hours. A previously healthy 37-year-old male presented with occipital headache, nausea,
vomiting, right-sided hemiparesis, within 30 minutes from the onset and NIHSS 18. The patient
was vaccinated against COVID-19 with Pfizer-BioNTech vaccine seven days before the onset. On
initial computed tomography (CT) scan, the pc-ASPECTS was 10 and CT angiography (CTA)
showed the tip of BA thrombosis. Intravenous thrombolytic therapy was administered, followed by
MT, achieving mTICI 3 and NIHSS 5 after the procedure. Within 24 hours from the first MT,
there was neurological deterioration followed by coma. Urgent CT/CTA was performed and rethrombosis
of BA was confirmed with pc-ASPECTS 10. MT was repeated with mTICI 2b. Stroke
etiology was undetermined. After 17 days, the patient was discharged and referred to continue rehabilitation
treatment. After 90 days of stroke, his NIHSS was 2 and mRS 1. We can consider that
early recurrent BAO can be successfully treated with repeated MT.

Keywords

Basilar artery occlusion; pc-ASPECT score; Mechanical thrombectomy; Thrombolysis

Hrčak ID:

315283

URI

https://hrcak.srce.hr/315283

Publication date:

1.11.2023.

Article data in other languages: croatian

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