# Distal protection of endovascular recanalization for symptomatic non-acute occlusion of vertebrobasilar artery

## TL;DR

This study shows that using distal protection during endovascular treatment for non-acute vertebrobasilar artery blockages is safe and reduces complications.

## Contribution

The study introduces the use of distal protection in endovascular recanalization for non-acute vertebrobasilar artery occlusions.

## Key findings

- All 8 patients achieved successful recanalization with the procedure.
- Periprocedural complications occurred in 25% of cases, including one asymptomatic hemorrhage and thrombus translocation.
- At 90 days, 75% of patients had a good outcome with a modified Rankin Scale score of 0–2.

## Abstract

The research aimed to investigate the safety and efficacy of distal protection of endovascular recanalization for symptomatic non-acute occlusion of the intracranial vertebrobasilar artery.

8 consecutive patients with symptomatic non-acute VBA from April 2023 to April 2024 who underwent endovascular recanalization were retrospectively analyzed.

8 patients (median age 56 years; mean pretreatment National Institutes of Health Stroke Scale (NIHSS) score 6; 87.5% male) presenting with recurrent transient ischemic attacks(TIAs) (n = 1) or strokes (n = 23) were treated from April 2023 to April 2024. Median time from symptoms onset to treatment was 21 days(range: 10–43). Median time from occlusion confirmed to treatment was 13 days(range:8–26). Among the 8 patients, 8 (100%) achieved successful recanalization. The rate of periprocedural complications was 25%(2/8). Periprocedural complication included one asymptomatic intracranial hemorrhage(asICH) and thrombus translocation. The median follow-up time was 9 months (range: 6–12), with no stroke or TIA. At 90 days, there were one death (unrelated to the procedure) and 75% patients with an available modified Rankin Scale (mRS) score achieved a good outcome (mRS score of 0–2).

The distal protection of stent retriever for endovascular recanalization for symptomatic non-acute occlusion of VBA is technically safe and may decrease procedure-related complications.