Effectiveness of Intracranial Percutaneous Transluminal Angioplasty or Stenting for Atherosclerotic Vertebrobasilar Artery Occlusion in the Acute Phase of Ischemic Stroke

详细信息    查看全文

• 作者：Daisuke Wajima¹ ; ² ; ^{wajima@naramed-u.ac.jp} ; Shuta Aketa² ; Ichiro Nakagawa¹ ; Katsuya Masui² ; Taiji Yonezawa² ; Tomomi Enami³ ; Fukuko Nishida³ ; Hiroyuki Nakase¹
• 关键词：Intracranial stenting ; Ischemic complications ; Percutaneous transluminal angioplasty (PTA) ; Symptomatic atherosclerotic vertebrobasilar artery occlusion
• 刊名：World Neurosurgery
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：97
• 期：Complete
• 页码：253-260
• 全文大小：3003 K
• 卷排序：97

文摘

Although short-term clinical outcomes after basilar artery stent placement have been reported previously, effectiveness of intracranial stenting for vertebrobasilar artery occlusion in the acute phase of ischemic stroke is unclear.MethodsWe clinically investigated 8 patients with intracranial percutaneous transluminal angioplasty (PTA) or stenting as our protocol for symptomatic atherosclerotic vertebrobasilar artery occlusion (age range, 54–80 years; mean age, 69 ± 11 years; 6 men and 2 women) who were admitted to our hospital between August 2013 and December 2015.ResultsTwo patients underwent PTA of the vertebrobasilar artery 2–5 months before stent placement. The other 6 patients underwent intracranial stenting just after PTA. Within the first 30 days after vertebrobasilar artery stent placement, 2 ischemic stroke complications affected patients. Ischemic complications were significantly associated with prestent lesion lumen greater than 0.5 mm. The modified Rankin Scale score and clinical outcome were significantly associated with complications. Clinical outcomes correlate with ischemic complications and vertebrobasilar anatomy.ConclusionsStent angioplasty may be a reasonably good treatment option for patients with technically favorable lesions, especially in vertebrobasilar atherosclerotic occlusion with medically or PTA only refractory symptoms. Despite a significant complication rate, most of our patients experienced good to excellent clinical outcomes and were free of vertebrobasilar ischemia at late midterm follow-up.