Advanced

AJNR - American Journal of Neuroradiology

Published ahead of print on March 11, 2009
doi: 10.3174/ajnr.A1427

This Article Free to Access Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A1427v1 30/4/840    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Du, B. Articles by Jiang, W.-J. Search for Related Content PubMed PubMed Citation Articles by Du, B. Articles by Jiang, W.-J.

American Journal of Neuroradiology 30:840-844, April 2009
© 2009 American Society of Neuroradiology

INTERVENTIONAL

Long-Term Outcome of Tandem Stenting for Stenoses of the Intracranial Vertebrobasilar Artery and Vertebral Ostium

B. Du^a, E.H.C. Wong^a and W.-J. Jiang^a

^a From the Department of Neurology and Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

Please address correspondence to Wei-Jian Jiang, MD, Department of Neurology and Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Beijing 100050, China; e-mail: cjr.jiangweijian{at}vip.163.com

BACKGROUND AND PURPOSE:Patients with symptomatic atherosclerotic stenosis of the intracranial vertebrobasilar artery (VBA) have a poor prognosis, and those with coexistent intracranial and extracranial stenoses have worse outcomes despite medical therapy. Our aim was to study the long-term outcome of patients with symptomatic atherosclerotic tandem stenoses at the intracranial VBA and the vertebral artery ostium (VAO) after elective stent placement.

MATERIALS AND METHODS:Ten consecutive patients (mean age, 65.3 years) with this condition underwent elective stent placement at our institution between September 2001 and December 2007. Technical success was defined as stent placement of both VAO and intracranial VBA stenoses with complete stent coverage of the lesions, residual stenosis of 30%, and good antegrade blood flow. The study end point was a composite of any stroke or death within 30 days and ischemic stroke in the VBA territory after 30 days.

RESULTS:Technical success was obtained in 9 of 10 patients without any stroke or death within 30 days. During a median follow-up duration of 32 months, 1 patient had a fatal ischemic stroke in the VBA territory at 4 months, and the other 9 patients were free from stroke recurrence. Thus, the annual stroke rate in VBA territory (including any stroke or death within 30 days) was 3.8%.

CONCLUSIONS:This pilot study shows that elective stent placement for patients with symptomatic atherosclerotic tandem stenoses at the intracranial VBA and VAO has an acceptable long-term outcome and may be considered as an alternative to medical therapy.