American Journal of Neuroradiology 21:1293-1301 (7 2000)
© 2000 American Society of Neuroradiology
ARTICLE
Intracranial Vertebrobasilar Stenosis:Angioplasty and Follow-up
a From the Departments of Neuroradiology (H.C.N., H.H., W.W., T.A.Y., D.K.) and Neurology (E.B-D.), Alfried-Krupp Krankenhaus, Essen, Germany; and the Department of Neuroradiology, Klinikum Grosshadern, Ludwig-Maximilians-Universität, Munich, Germany (T.A.Y.).
BACKGROUND AND PURPOSE: When medication fails to improve symptoms of atherosclerotic stenosis of the intracranial vertebral and basilar arteries, percutaneous transluminal angioplasty (PTA) is considered. However, because investigators disagree on the usefulness of this procedure, we conducted a retrospective study to evaluate the indications, efficacy, and safety of PTA.
METHODS: Twenty patients underwent PTA of the vertebral (n = 14) or basilar (n = 6) artery, 18 for neurologic signs and symptoms of arterial stenosis that recurred or progressed despite pharmacotherapy and two prophylactically. Neurologic examinations were performed before and after the procedure and arterial patency was evaluated at follow-up by digital subtraction angiography and/or MR angiography. Imaging follow-up was available for 14 (70%) of the 20 patients, neurologic follow-up for 15 (75%).
RESULTS: The stenosis was successfully dilated in all patients, and on follow-up neuroradiologic examinations, vessel patency could be seen in 12 (86%) of 14 patients. Only one (7%) of 15 patients who returned for a follow-up neurologic examination had new symptoms (caused by occlusion of the vertebral artery 4 months after the procedure). One patient had a reversible neurologic deficit and one had hemiparesis after PTA. No patient died as a result of PTA.
CONCLUSION: In our study, PTA of intracranial vertebrobasilar arteries was associated with a low mortality and morbidity rate and with a high degree of patency. This technique may therefore be regarded as an effective means of improving the patency of stenotic arteries. In selective cases, it might be considered for use prophylactically.
This article has been cited by other articles:
 |
|
 |
|
  F. Siddiq, G. Vazquez, M. Z. Memon, M. F. K. Suri, R. A. Taylor, J. C. Wojak, J. C. Chaloupka, and A. I. Qureshi Comparison of Primary Angioplasty With Stent Placement for Treating Symptomatic Intracranial Atherosclerotic Diseases: A Multicenter Study Stroke, September 1, 2008; 39(9): 2505 - 2510. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Fiorella and H. H. Woo Emerging Endovascular Therapies for Symptomatic Intracranial Atherosclerotic Disease Stroke, August 1, 2007; 38(8): 2391 - 2396. [Full Text] [PDF]
|
|
|
|
|
|
L. J. Coward, D. J.H. McCabe, J. Ederle, R. L. Featherstone, A. Clifton, M. M. Brown, and on behalf of the CAVATAS Investigators Long-Term Outcome After Angioplasty and Stenting for Symptomatic Vertebral Artery Stenosis Compared With Medical Treatment in the Carotid And Vertebral Artery Transluminal Angioplasty Study (CAVATAS): A Randomized Trial Stroke, May 1, 2007; 38(5): 1526 - 1530. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Bose, M. Hartmann, H. Henkes, H. M. Liu, M. M.H. Teng, I. Szikora, A. Berlis, J. Reul, S. C.H. Yu, M. Forsting, et al. A Novel, Self-Expanding, Nitinol Stent in Medically Refractory Intracranial Atherosclerotic Stenoses: The Wingspan Study Stroke, May 1, 2007; 38(5): 1531 - 1537. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.C. Wojak, D.C. Dunlap, K.R. Hargrave, L.A. DeAlvare, H.S. Culbertson, and J.J. Connors III Intracranial angioplasty and stenting: long-term results from a single center. AJNR Am. J. Neuroradiol., October 1, 2006; 27(9): 1882 - 1892. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Intracranial Angioplasty & Stenting for Cerebral Atherosclerosis: A Position Statement of the American Society of Interventional and Therapeutic Neuroradiology, Society of Interventional Radiology, and the American Society of Neuroradiology AJNR Am. J. Neuroradiol., October 1, 2005; 26(9): 2323 - 2327. [Full Text] [PDF]
|
|
|
|
|
|
T. E. Mayer, G. F. Hamann, G. Schulte-Altedorneburg, and H. Bruckmann Treatment of Vertebrobasilar Occlusion by Using a Coronary Waterjet Thrombectomy Device: A Pilot Study AJNR Am. J. Neuroradiol., June 1, 2005; 26(6): 1389 - 1394. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Amin-Hanjani, X. Du, M. Zhao, K. Walsh, T. W. Malisch, and F. T. Charbel Use of Quantitative Magnetic Resonance Angiography to Stratify Stroke Risk in Symptomatic Vertebrobasilar Disease Stroke, June 1, 2005; 36(6): 1140 - 1145. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. J. Connors III, D. Sacks, A. J. Furlan, W. R. Selman, E. J. Russell, P. E. Stieg, M. N. Hadley, and for the NeuroVascular Coalition Writing Group Training, competency, and credentialing standards for diagnostic cervicocerebral angiography, carotid stenting, and cerebrovascular intervention: A Joint Statement from the American Academy of Neurology, the American Association of Neurological Surgeons, the American Society of Interventional and Therapeutic Neuroradiology, the American Society of Neuroradiology, the Congress of Neurological Surgeons, the AANS/CNS Cerebrovascular Section, and the Society of Interventional Radiology Neurology, January 25, 2005; 64(2): 190 - 198. [Full Text] [PDF]
|
|
|
|
|
|
T. H. Lee, D. H. Kim, B.-H. Lee, H. J. Kim, C. H. Choi, K. P. Park, D. S. Jung, S. Kim, and T. Y. Moon Preliminary Results of Endovascular Stent-Assisted Angioplasty for Symptomatic Middle Cerebral Artery Stenosis AJNR Am. J. Neuroradiol., January 1, 2005; 26(1): 166 - 174. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. J. Connors III, D. Sacks, A. J. Furlan, W. R. Selman, E. J. Russell, P. E. Stieg, M. N. Hadley, and For the NeuroVascular Coalition Writing Group Training, Competency, and Credentialing Standards for Diagnostic Cervicocerebral Angiography, Carotid Stenting, and Cerebrovascular Intervention: A Joint Statement from the American Academy of Neurology, American Association of Neurological Surgeons, American Society of Interventional and Therapeutic Radiology, American Society of Neuroradiology, Congress of Neurological Surgeons, AANS/CNS Cerebrovascular Section, and Society of Interventional Radiology Radiology, January 1, 2005; 234(1): 26 - 34. [Full Text] [PDF]
|
|
|
|
 |
|
 G.C. Cloud and H.S. Markus Diagnosis and management of vertebral artery stenosis QJM, January 1, 2003; 96(1): 27 - 54. [Full Text] [PDF]
|
|
|
|
 |
|
 C. R. Gomez and S. C. Orr Angioplasty and Stenting for Primary Treatment of Intracranial Arterial Stenoses Arch Neurol, October 1, 2001; 58(10): 1687 - 1690. [Full Text] [PDF]
|
|
|
|
|
|
M. I. Chimowitz Angioplasty or Stenting Is Not Appropriate as First-Line Treatment of Intracranial Stenosis Arch Neurol, October 1, 2001; 58(10): 1690 - 1692. [Full Text] [PDF]
|
|
|
|
|
|
Angioplasty and Stenting of Extracranial Brachiocephalic Stenoses (Other Than the Cervical Carotid Bifurcation) and Intracranial Stenoses AJNR Am. J. Neuroradiol., September 1, 2001; 22(2007): 31S - 33S. [Full Text] [PDF]
|
|