American Journal of Neuroradiology 23:430-436, March 2002
© 2002 American Society of Neuroradiology
INTERVENTIONAL
Angioplasty and Stent Placement in Intracranial Atherosclerotic Stenoses and Dissections
a From the Department of Neurosurgery and Interventional Neuroradiology, Eneri, Clinica Medica Belgrano, Buenos Aires, Argentina
Address reprint requests to Pedro Lylyk, MD, Sanchez de Bustamante 2184, PB Dpto B (1425), Buenos Aires, Argentina
BACKGROUND AND PURPOSE: Stent placement has been shown to increase the safety and effectiveness of balloon angioplasty in cervical carotid disease. Here, the authors investigated the feasibility, safety, and short-term outcome of stent-assisted angioplasty for the treatment of intracranial stenoses.
METHODS: Thirty-four patients (age range, 12–77 years; mean age, 54 years) with symptomatic intracranial atherosclerotic lesions and dissections that produced stenosis of more than 50% were selected and treated with stents. Eighteen lesions (53%) were located in the anterior circulation, and 16 (47%) were in the vertebrobasilar complex. The mean stenosis was 75%.
RESULTS: At follow up, 21 patients (62%) improved clinically, 11 (32%) remained stable, and the condition of two patients (6%) deteriorated. In all patients, the angiographic degree of stenosis was reduced to less than 30%. In 10 patients (29%), two or more stents were implanted: Two stents were implanted in six patients, and three, in four patients. The transient procedural morbidity rate was 12%, and the transient neurologic morbidity rate was 6%. One patient had hemorrhagic transformation due to reperfusion and died, and another patient had a massive myocardial infarction after 5 months. Twenty patients were followed up with angiography for at least 6 months, and none required repeat angioplasty.
CONCLUSION: Endovascular revascularization of intracranial arteries by means of stent-assisted angioplasty is technically feasible, effective, and safe in selected patients.
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