TY - JOUR T1 - Transluminal Angioplasty and Stenting for Intracranial Vertebrobasilar Occlusive Lesions in Acute Stroke Patients JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 773 LP - 780 DO - 10.3174/ajnr.A0906 VL - 29 IS - 4 AU - K. Imai AU - T. Mori AU - H. Izumoto AU - T. Kunieda AU - N. Takabatake AU - S. Yamamoto AU - M. Watanabe Y1 - 2008/04/01 UR - http://www.ajnr.org/content/29/4/773.abstract N2 - BACKGROUND AND PURPOSE: The clinical outcome is often poor in acute stroke patients with a serious neurological status due to occlusive lesions of the intracranial vertebral and/or basilar artery (IVBA). The purpose of this study was to investigate retrospectively the clinical features and outcome of acute stroke patients who underwent transluminal angioplasty and/or stenting (TAS) for occlusive lesions of the IVBA and to clarify the prerequisites for improvement of outcome.MATERIALS AND METHODS: Of 1690 consecutive acute ischemic stroke patients admitted to our institution, TAS for occlusive lesions of the IVBA was performed within 7 days after stroke onset in 28 patients. We classified these patients into 2 groups, those with total occlusion (occlusion group) and those with a high-grade stenosis (stenosis group), and compared the preprocedural neurologic status (severe: National Institutes of Health Stroke Scale >20), the rate of technical success, major procedure-related complications, subacute occlusion of the treated vessel, and favorable clinical outcome (0-2 points on a 3-month modified Rankin Scale) between the 2 groups.RESULTS: In the occlusion group (n = 16) and stenosis group (n = 12), a severe preprocedural neurologic status was seen in 13 and 1 patients, respectively (81% versus 8%; P = .0001); technical success was achieved in 13 and 11 patients, respectively (81% versus 92%; P value not significant [NS]); complications occurred in 6 and 0 patients, respectively (38% versus 0%; P < .05); subacute occlusion was seen in 4 and 1 patients, respectively (25% versus 8%; P = NS); and a favorable clinical outcome was obtained in 3 and 9 patients, respectively (19% versus 75%; P < .01).CONCLUSION: The clinical outcome of patients who underwent TAS for total occlusion of the IVBA was poor. Improvement of outcome requires reduction of procedure-related complications and subacute occlusion. ER -