Angioplasty and Stenting in the Posterior Cerebral Circulation

Abstract

Purpose:

To report initial experience with intracranial vertebral artery (VA) and basilar artery (BA) percutaneous transluminal angioplasty (PTA) and stenting.

Methods:

Eleven patients (10 men; mean age 66 years, range 56–75) with intracranial 14 VA and 3 BA stenoses were managed from December 1997 through November 1999. All patients presented with vertebrobasilar ischemia (VBI) despite antiplatelet and anticoagulant therapy. Clinical presentations included visual disturbance (n = 8), dysarthria/dysphasia (n = 5), and vertigo (n = 5).

Results:

Five patients underwent PTA only of 7 lesions with a mean preprocedural stenosis of 80% (range 50%–90%) that was reduced to 54% (range 30%–70%) after dilation. Six patients received 9 stents, 2 for VA dissections, 3 for tandem lesions, and 1 for a BA lesion. There were no embolic strokes. Patients were followed by clinical evaluation and personal or telephone interviews. Over a mean 18-month follow-up (range 12–35), 8 (73%) patients remained asymptomatic, while 3 (27%) had permanent deficits, 2 related to the procedure and 1 owing to distal disease

Conclusions:

Intracranial VA or BA angioplasty and stenting alleviated symptoms in patients with vertebrobasilar ischemia despite best medical management and may prevent stroke.

Keywords

vertebral artery basilar artery dissection perforation neurological deficit

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