Abstract
Percutaneous transluminal balloon angioplasty (PTA) has been used in the treatment of critical stenosis of the intracranial vertebrobasilar artery (VBA). PTA of the intracranial VBA carries the risk of fatal complications such as arterial dissection or acute occlusion as well as postoperative restenosis. The estimated risk of periprocedural complications and restenosis were approximately 20% and 27%. The use of recently developed stents could prevent these problems of PTA. We present two cases of restenosis of the intracranial VBA after PTA which stenoses were successfully retreated with endovascular stenting using flexible coronary stents without any complications. Neither restenosis nor other recurrent symptoms were observed during the 4- and 6-month follow-up period. Reviewing the literature of 33 cases and our 2 cases, the overall complication rates related to stenting and restenosis were 5.6% and 7.8%. Endovascular stenting for the treatment of intracranial VBA can reduce the risk of arterial dissection and restenosis.
Similar content being viewed by others
References
PT Akins PT K DT Cross CJ Moran (1998) ArticleTitleNatural history of stenosis from intracranial atherosclerosis by serial angiography. Stroke 29 433–438 Occurrence Handle1:STN:280:DyaK1c7jt1ahug%3D%3D Occurrence Handle9472886
InstitutionalAuthorNameThe Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Study Group (1998) ArticleTitlePrognosis of patients with symptomatic vertebral or basilar artery stenosis. Stroke 29 1389–1392
JI Ausman FG Diaz DF Vacca B Sadasivan (1990) ArticleTitleSuperficial temporal and occipital artery bypass pedicles to superior, anterior inferior, and posterior inferior cerebellar arteries for vertebrobasilar insufficiency. J Neurosurg 72 554–558 Occurrence Handle1:STN:280:By%2BB3cvgtFI%3D Occurrence Handle2319313
T Terada RT Higashida VV Halbach CF Dowd E Nakai H Yokote T Itakura GB Hieshima (1996) ArticleTitleTransluminal angioplasty for arteriosclerotic diseases of the distal vertebral and basilar arteries. J Neurol Neurosurg Psychiatry 60 377–381
HC Nahser H Henkes W Weber E Berg-Dammer TA Yousry D Kühne (2000) ArticleTitleIntracranial vertebrobasilar stenosis: angioplasty and follow-up. Am J Neuroradiol 21 1293–1301 Occurrence Handle1:STN:280:DC%2BD3M%2FotlOntQ%3D%3D Occurrence Handle10954282
C Takis ES Kwan MS Pessin DH Jacobs LR Caplan (1997) ArticleTitleIntracranial angioplasty: experience and complications. Am J Neuroradiol 18 1661–1668 Occurrence Handle1:STN:280:DyaK1c%2FjtlWgtA%3D%3D Occurrence Handle9367313
C Jimenez H Duong M Olarte J Pile-Spellman (1999) ArticleTitleRecurrent abrupt occlusion after transluminal angioplasty for basilar artery stenosis: case report. Neurosurgery 44 210–215 Occurrence Handle10.1097/00006123-199901000-00127 Occurrence Handle1:STN:280:DyaK1M7htVaktw%3D%3D Occurrence Handle9894984
CC Phatouros RT Higashida AM Malek WS Smith TW Mully SJ DeArmond CF Dowd VV Halbach (1999) ArticleTitleEndovascular stenting of an acutely thrombosed basilar artery: technical case report and review of the literature. Neurosurgery 44 667–673 Occurrence Handle10.1097/00006123-199903000-00134 Occurrence Handle1:STN:280:DyaK1M7mslWgtQ%3D%3D Occurrence Handle10069607
MS Barakate CM Fisher M Appleberg MA Farrar RV Tse TJ Harrington W Sorby (2001) ArticleTitleCombined endovascular and open surgery for four-vessel cerebrovascular occlusive disease. J Endovasc Ther 8 62–66 Occurrence Handle10.1583/1545-1550(2001)008<0062:CEAOSF>2.0.CO;2 Occurrence Handle1:STN:280:DC%2BD3M7ktlehsA%3D%3D Occurrence Handle11220471
G Lanzino RD Fessler RS Miletich LR Guterman LN Hopkins (1999) ArticleTitleAngioplasty and stenting of basilar artery stenosis: technical case report. Neurosurgery 45 404–408 Occurrence Handle10.1097/00006123-199908000-00047 Occurrence Handle1:STN:280:DyaK1Mzns1egsg%3D%3D Occurrence Handle10449090
PP Morris EM Martin J Regan G Braden (1999) ArticleTitleIntracranial deployment of coronary stents for symptomatic atherosclerotic disease. Am J Neuroradiol 20 1688–1694 Occurrence Handle1:STN:280:DC%2BD3c%2FgvV2rtQ%3D%3D Occurrence Handle10543642
MB Horowitz GL Pride DF Graybeal PD Purdy (1999) ArticleTitlePercutaneous transluminal angioplasty and stenting of midbasilar stenoses: three technical case reports and literature review. Neurosurgery 45 925–931 Occurrence Handle10.1097/00006123-199910000-00043 Occurrence Handle1:STN:280:DyaK1MvktlGitw%3D%3D Occurrence Handle10515492
T Mori K Kazita K Chokyu T Mima K Mori (2000) ArticleTitleShort-term arteriographic and clinical outcome after cerebral angioplasty and stenting for intracranial vertebrobasilar and carotid atherosclerotic occlusive disease. Am J Neuroradiol 21 249–254 Occurrence Handle1:STN:280:DC%2BD3c7lvVGmsw%3D%3D Occurrence Handle10696004
CR Gomez VK Misra MW Liu VR Wadlington JB Terry R Tulyapronchote MS Campbell (2000) ArticleTitleElective stenting of symptomatic basilar artery stenosis. Stroke 31 95–99 Occurrence Handle1:STN:280:DC%2BD3c%2FptlSiug%3D%3D Occurrence Handle10625722
PA Rasmussen J Perl II JD Barr GZ Merkarian I Katzan C Sila D Krieger AJ Furlan TJ Masaryk (2000) ArticleTitleStent-assisted angioplasty of intracranial vertebrobasilar atherosclerosis: an initial experience. J Neurosurg 92 771–778
TM Jr Sundt HC Smith JK Campbell RE Vliestra RF Cucchiara AW Stanson (1980) ArticleTitleTransluminal angioplasty for basilar artery stenosis. Mayo Clin Prosc 55 673–680
WM Clark SL Branwell G Nesbit OR O’Neil ML Wynn BM Coull (1995) ArticleTitleSafety and efficacy of percutaneous transluminal angioplasty for intracranial atherosclerotic stenosis. Stroke 26 1200–1204 Occurrence Handle1:STN:280:ByqA38fhtVI%3D Occurrence Handle7604414
MP Marks M Marcellus AM Norbash GK Steinberg D Tong GW Albers (1999) ArticleTitleOutcome of angioplasty for atherosclerotic intracranial stenosis. Stroke 30 1065–1069 Occurrence Handle1:STN:280:DyaK1M3kvVegsw%3D%3D Occurrence Handle10229745
AK Wakhloo FO Tio BB Lieber F Schellhammer M Graf LN Hopkins (1995) ArticleTitleSelf-expandable nitinol stents in vertebral arteries. Am J Neuroradiol 16 1043–1051 Occurrence Handle1:STN:280:ByqA28njsVw%3D Occurrence Handle7639126
T Mori M Fukuoka K Kazita K Mori (1998) ArticleTitleFollow-up study after intracranial percutaneous transluminal cerebral balloon angioplasty. Am J Neuroradiol 19 1525–1533 Occurrence Handle1:STN:280:DyaK1cvjsVemsQ%3D%3D Occurrence Handle9763389
T Mori K Mori M Fukuoka M Arisawa S Honda (1997) ArticleTitlePercutaneous transluminal cerebral angioplasty: serial angiographic follow-up after successful dilatation. Neuroradiology 39 111–116 Occurrence Handle10.1007/s002340050376 Occurrence Handle1:STN:280:ByiC1MjmslE%3D Occurrence Handle9045971
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kiyosue, H., Okahara, M., Yamashita, M. et al. Endovascular Stenting for Restenosis of the Intracranial Vertebrobasilar Artery After Balloon Angioplasty: Two Case Reports and Review of the Literature. CVIR 27, 538–543 (2004). https://doi.org/10.1007/s00270-004-0469-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00270-004-0469-7