Abstract：
OBJECTIVE: The acute vertebrobasilar occlusion associated with the poor prognosis, particularly tandem occlusion. However, few data on the efficacy of the endovascular therapy was indicated in this occlusion. We investigated whether the additional rescue extracranial vertebral stenting improved clinical outcome by modified Rankin scale (mRS) score within 3 months after the procedure.
METHODS: This was a retrospective analysis of patients with acute posterior tandem occlusion who were treated with rescue extracranial vertebral stenting between December 2020 and January 2024 at our hospital. Clinical, neuroimaging, procedural, and complication data were collected. Primary outcomes included the rate of good outcomes (mRS ≤ 2) at 3-month follow-up.
RESULTS: Nine patients who underwent rescue extracranial vertebral stenting in posterior circulation tandem occlusions were enrolled in the study. All patients were achieved the successful recanalization (mTICI ≥ 2b). Of Dotter technique in the \"distal-to-proximal\" approach, Diagnostic-Dotter made up 66.7%. Five patients (55.6%) with good outcome (mRS ≤ 2) at 3 months, and 1 patient (11.1%) underwent suboccipital decompressive craniectomy due to the malignant cerebellar infarction.
CONCLUSIONS: Our study suggests that despite the small series with posterior tandem occlusions, the rescue extracranial vertebral stenting could be an important alternative treatment followed by mechanical thrombectomy.
METHODS: This was a retrospective analysis of patients with acute posterior tandem occlusion who were treated with rescue extracranial vertebral stenting between December 2020 and January 2024 at our hospital. Clinical, neuroimaging, procedural, and complication data were collected. Primary outcomes included the rate of good outcomes (mRS ≤ 2) at 3-month follow-up.
RESULTS: Nine patients who underwent rescue extracranial vertebral stenting in posterior circulation tandem occlusions were enrolled in the study. All patients were achieved the successful recanalization (mTICI ≥ 2b). Of Dotter technique in the \"distal-to-proximal\" approach, Diagnostic-Dotter made up 66.7%. Five patients (55.6%) with good outcome (mRS ≤ 2) at 3 months, and 1 patient (11.1%) underwent suboccipital decompressive craniectomy due to the malignant cerebellar infarction.
CONCLUSIONS: Our study suggests that despite the small series with posterior tandem occlusions, the rescue extracranial vertebral stenting could be an important alternative treatment followed by mechanical thrombectomy.
摘要：
目的：急性椎基底动脉闭塞与预后不良相关，特别是串联闭塞。然而,在这种闭塞中,关于血管内治疗疗效的数据很少.我们在术后3个月内通过改良Rankin量表（mRS）评分调查了额外的抢救颅外椎体支架置入术是否改善了临床预后。
方法：回顾性分析我院2020年12月至2024年1月接受颅外椎管内支架置入治疗的急性后路串联闭塞患者的临床资料。临床,神经影像学,程序,收集并发症数据。主要结局包括3个月随访时的良好结局率（mRS≤2）。
结果：9例接受后循环串联闭塞的颅外椎管内支架置入术的患者纳入研究。所有患者均成功再通（mTICI≥2b）。在“远端到近端”方法中的Dotter技术，诊断率占66.7%。5例（55.6%）在3个月时预后良好（mRS≤2），1例(11.1%)因恶性小脑梗死行枕下去骨瓣减压术。
结论：我们的研究表明，尽管有少量的后部串联闭塞，抢救性颅外椎体支架置入术可能是机械血栓切除术后的重要替代治疗方法。
方法：回顾性分析我院2020年12月至2024年1月接受颅外椎管内支架置入治疗的急性后路串联闭塞患者的临床资料。临床,神经影像学,程序,收集并发症数据。主要结局包括3个月随访时的良好结局率（mRS≤2）。
结果：9例接受后循环串联闭塞的颅外椎管内支架置入术的患者纳入研究。所有患者均成功再通（mTICI≥2b）。在“远端到近端”方法中的Dotter技术，诊断率占66.7%。5例（55.6%）在3个月时预后良好（mRS≤2），1例(11.1%)因恶性小脑梗死行枕下去骨瓣减压术。
结论：我们的研究表明，尽管有少量的后部串联闭塞，抢救性颅外椎体支架置入术可能是机械血栓切除术后的重要替代治疗方法。
