Stenting of symptomatic basilar and vertebral artery stenosis in patients resistant to optimal medical prevention: the lyon stroke unit experience.

Abstract:

UNLABELLED:Intracranial angioplasty stenting may be an efficient therapy in patients with intracranial atherosclerotic symptomatic vertebrobasilar artery stenosis unresponsive to optimal medical therapy. We present our experience in this setting. RESULTS:The study included 12 cases (8 men, 4 women), with an age range of 43-78 years (mean 62.6 years). Intracranial stenosis that resulted in qualifying stroke or transient ischemic attack involved the vertebral artery (n = 4), lower basilar artery (n = 1) and mid basilar artery (n = 5). Tandem stenosis included the intracranial vertebral artery and basilar artery (n = 1) and both intracranial vertebral arteries (n = 1). The degree of stenosis ranged between 70 and 90% in the basilar and vertebral arteries. Angioplasty + stenting was performed in all lesions. A successful procedure resulting in 30% of residual stenosis was found in 14 vessels. A periprocedural adverse event occurred in 1 case and was related to a brain hemorrhage. The mean patient follow-up was 15 +/- 3 months; 10 patients remained symptom free. All patients underwent a percutaneous endovascular balloon angioplasty and stent placement. CONCLUSIONS:This study supports the safety and the potential efficiency of stent-assisted angioplasty in patients resistant to optimal prevention. Randomized larger prospective trials are needed to confirm the benefit of this approach.

journal_name

Eur Neurol

journal_title

European neurology

authors

Ralea IC,Nighoghossian N,Tahon F,Derex L,Cakmak S,Trouillas P,Turjman F

doi

10.1159/000144082

subject

Has Abstract

pub_date

2008-01-01 00:00:00

pages

127-31

issue

3

eissn

0014-3022

issn

1421-9913

pii

000144082

journal_volume

60

pub_type

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