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| 篇名 |
Balloon angioplasty followed by aspiration of large‑vessel occlusion (BAFALO): An efficient and protective treatment of tandem occlusion |
| 作者 |
Kuo‑Wei Chen, Yen‑Heng Lin, Chiu‑Hao Hsu, Chi‑Ju Lu, Sung‑Chun Tang, Chung‑Wei Lee, Pin‑Yi Chiang |
| 卷期/出版年月 |
55卷6期 (2022/11) |
| 頁次 |
199-206 |
| 摘要 |
Background: Endovascular thrombectomy (EVT) for acute ischemic stroke associated with tandem lesion
is challenging. Achieving rapid intracranial revascularization and managing the extracranial lesion without
complications are the main challenges.
Materials and Methods: The balloon angioplasty followed by aspiration of large‑vessel occlusion (BAFALO) technique
was used to address this clinical issue. A review of a prospectively maintained stroke registry from January 2015
to April 2020 was performed. Patients had stroke with TO and treated with the BAFALO technique were included.
Results: Twelve patients were enrolled: 11 had anterior circulation stroke, and 1 had posterior circulation
stroke. There were 10 ipsilateral internal carotid artery stenosis/occlusion, one left common carotid artery
to subclavian artery bypass stenosis, and 1 vertebral artery orifice stenosis. The median National Institutes
of Health Stroke Scale score was 16 (interquartile range [IQR]: 14–16). Revascularization with a Modified
Thrombolysis in Cerebral Infarction score of 2b or more was achieved in 11 (92%) patients. The median
puncture‑to‑revascularization time was 25 min (IQR: 19.5–31). Emergent stent implantation was performed
in five (42%) patients. Three had distal protection devices (DPDs) with no distal embolization. Two patients
did not use a DPD, and one had intracranial reocclusion. Eight (67%) proximal stenotic vessels remained
patent. No symptomatic intracranial hemorrhage occurred. Eight (67%) patients had favorable clinical
outcomes (modified Rankin Score 0–2 at 90 days).
Conclusion: While managing TO, the BAFALO technique could achieve rapid intracranial revascularization and
treat extracranial lesions under embolic protection. These merits translate into favorable clinical outcomes. |
| 關鍵詞 |
Acute stroke, endovascular thrombectomy, tandem lesion |
| 分類 |
Original Articles |
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