Thrombectomy using Trevo ProVue Stent Retriever Devices after Recombinant Tissue Plasminogen Activator Thrombolysis for Acute Basilar Artery Occlusion during Vertebral Artery Dissection

摘要

A 41-year-old woman was admitted due to a sudden-onset severe headache, left hemiparesis and dysarthria. Diffusion-weighted magnetic resonance imaging showed an acute infarct in the bilateral pons, and magnetic resonance angiography revealed basilar artery (BA) occlusion resulting from dissection of the right vertebral artery (VA). She was treated with intravenous recombinant tissue plasminogen activator (rt-PA) 110 minutes after symptom onset. Subsequently, brain angiography was performed along with mechanical thrombolysis using Trevo ProVue retriever devices. The BA was successfully recanalized 240 minutes after the onset of symptoms. Thrombectomy is a promising treatment strategy for cases of VA dissection resistant to intravenous rt-PA thrombolysis.