Consilium MedicumConsilium Medicum2075-17532542-2170Consilium Medicum94382Research ArticleReperfusion therapy in ischemic stroke in the vertebrobasilar systemTolmachevA. Ptap87@mail.ruAnisimovK. V-ShamalovN. A-N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation15022016182182128122021Copyright © 2016, Consilium Medicum2016Ischemic stroke in the vertebrobasilar system (VBS) is characterized by a high rate of mortality and the significant rate of disability in survivors. Implementation of reperfusion therapy in patients with localization of the lesion in the SVD in some cases is a safe and effective outside the 4.5-hour time frame. Actively developing current methods of endovascular treatment of acute ischemic stroke, provide additional opportunities to increase the frequency of recanalization and, as a consequence, improve the degree of functional recovery in this patient group.ischemic strokereperfusion therapyvertebral-basilar systemишемический инсультреперфузионная терапиявертебрально-базилярная система[Caplan L. Posterior circulation ischemia: then, now, and tomorrow. The Thomas Willis Lecture-2000. Stroke 2000; 31 (8): 2011-23.][Gulli G, Khan S, Markus H.S. Vertebrobasilar stenosis predicts high early recurrent stroke risk in posterior circulation stroke and TIA. Stroke 2009; 40 (8): 2732-7.][Caplan L.R et al. New England Medical Center Posterior Circulation registry. Ann Neurol 2004; 56 (3): 389-98.][Gomez C.R et al. "Locked - in" syndrome. Stroke 1987; 18 (1): 275.][Антонов И.П., Гиткина Л.С. Вертебрально - базилярные инсульты. Минск: Беларусь, 1977.][Беков Д.Б., Михайлов С.С. Атлас артерий и вен головного мозга человека. Москва: Медицина, 1979.][Верещагин Н.В. Патология вертебрально - базилярной системы и нарушения мозгового кровообращения. М.: Медицина, 1980.][Шулешова Н.В., Вишневский А.А. Ствол головного мозга: Клиника и патофизиологические сопоставления. Спб: Гиппократ, 2006.][Беленькая Р.М. Инсульт и варианты артерий мозга. М.: Медицина, 1979.][Cao F, Hata R, Zhu P et al. Delayed neuronal cell death in brainstem after transient brainstem ischemia in gerbils. BMC Neurosci 2010; 14 (11): 115-126.][Hata R, Matsumoto M, Hatakeyama T et al. Differential vulnerability in the hindbrain neurons and local cerebral blood flow during bilateral vertebral occlusion in gerbils. Neuroscience 1993; 56: 423-39.][Millikan C.H, Siekert R.G, Shick R.M. Studies in cerebrovascular disease. The use of anticoagulant drugs in the treatment of insufficiency or thrombosis within the basilar arterial system. Proc Staff Meet Mayo Clin 1955; 30: 116-26.][Whisnant J.P. Cerebral vascular diseases: Third princeton conference on cerebrovascular diseases. Grune & Stratton 1961: 156-7.][Hacke W, Zeumer H, Ferbert A et al. Intra - arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease. Stroke 1988; 19: 1216-22.][Brandt T, von Kummer R, Muller-Kuppers M, Hacke W. Thrombolytic therapy of acute basilar artery occlusion. Variables affecting recanalization and outcome. Stroke 1996; 27: 875-81.][Strbian D, Sairanen T, Silvennoinen H et al. Intravenous Thrombolysis of Basilar Artery Occlusion: Thrombus Length Versus Recanalization Success. Stroke 2014; 45 (6): 1733-8.][Lindsberg P.J, Mattle H.P. Therapy of basilar artery occlusion: a systematic analysis comparing intra - arterial and intravenous thrombolysis. Stroke 2006; 37 (3): 922-8.][Broussalis E, Hitzl W, Mc Coy M et al. Comparison of endovascular treatment versus conservative medical treatment in patients with acute basilar artery occlusion. Vasc Endovascular Surg 2013; 47 (6): 429-37.][Schonewille W.J, Wijman C.A, Michel P et al. Treatment and outcomes of acute basilar artery occlusion in the basilar artery international cooperation study (basics): A prospective registry study. Lancet Neurol 2009; 8: 724-30.][Pfefferkorn T, Mayer T.E, Opherk C et al. Staged escalation therapy in acute basilar artery occlusion: Intravenous thrombolysis and on - demand consecutive endovascular mechanical thrombectomy: Preliminary experience in 16 patients. Stroke 2008; 39: 1496-500.][Martin-Schild S, Morales M.M, Khaja A.M et al. Is the drip - and - ship approach to delivering thrombolysis for acute ischemic stroke safe? J Emerg Med 2009.][Silverman I.E, Beland D.K, Chhabra J, Mc Cullough L.D. The "Drip - and - ship" Approach: Starting iv t - pa for acute ischemic stroke at outside hospitals prior to transfer to a regional stroke center. Conn Med 2005; 69: 613-20.][Pfefferkorn T, Holtmannspotter M, Schmidt C et al. Drip, ship, and retrieve: Cooperative recanalization therapy in acute basilar artery occlusion. Stroke 2010; 5-6: 722-6.][Mayer T.E, Hamann G.F, Brueckmann H.J. Treatment of basilar artery embolism with a mechanical extraction device: Necessity of flow reversal. Stroke 2002; 33: 2232-5.]