RT Journal Article
SR Electronic
T1 Transluminal Angioplasty and Stenting for Intracranial Vertebrobasilar Occlusive Lesions in Acute Stroke Patients
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 773
OP 780
DO 10.3174/ajnr.A0906
VO 29
IS 4
A1 Imai, K.
A1 Mori, T.
A1 Izumoto, H.
A1 Kunieda, T.
A1 Takabatake, N.
A1 Yamamoto, S.
A1 Watanabe, M.
YR 2008
UL http://www.ajnr.org/content/29/4/773.abstract
AB 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.