Impact of Superior Cerebellar Artery Occlusion after Thrombectomy for Acute Basilar Artery Occlusion

Abstract Occlusions of the superior cerebellar artery (SCA) are occasionally observed during thrombectomy in patients with posterior circulation stroke. This study aimed to investigate the incidence and clinical impact of SCA occlusion remaining after endovascular thrombectomy for acute basilar artery occlusion. We retrospectively analyzed data from 116 patients who underwent thrombectomy for basilar artery occlusion. The presence or absence of SCA occlusion was assessed on final angiograms. Clinical and radiologic data were compared between patients with and without SCA occlusion. All patients underwent pretreatment and follow-up diffusion-weighted imaging to detect new infarctions in SCA territory. Follow-up computed tomography angiography was performed to detect spontaneous recanalization of occluded SCAs. Ten patients (8.6%) had SCA occlusions on final angiograms. Of these, two patients had bilateral occlusions. A new infarction in corresponding SCA territory occurred in 5 of 10 patients and new midbrain infarction in one patient. The diameter of new infarctions ranged from 4 to 11mm. No patients with SCA occlusions experienced symptomatic cerebellar hemorrhage or malignant cerebellar infarction. There were no differences in the length of hospital stay, rates of favorable outcome, and mortality between patients with and without SCA occlusions. Nine of 12 (75%) SCA occlusions showed spontaneous recanalization. In conclusion, SCA occlusions remaining after thrombectomy for basilar artery occlusion had a benign clinical course. In addition, most of these lesions had recanalized spontaneously. Our study suggests that attempts to recanalize remnant SCA occlusion may be unnecessary after basilar artery thrombectomy.