Skip to main content
SpringerLink
Log in

Angioplasty or Stenting of Extra- and Intracranial Vertebral Artery Stenoses

  • Technical Note
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose: To determine the feasibility and safety of angioplasty or angioplasty and stenting of extra- and intracranial vertebral artery (VA) stenosis. Methods: In 16 consecutive patients (9 men, 7 women; mean age 61 years, range 49–74 years) 16 stenotic VAs were treated with angioplasty or angioplasty and stenting. Eleven stenoses were localized in V1 segment, 1 stenosis in V2 segment and 4 stenoses in V4 segment of VA. Fourteen VA stenoses were symptomatic, 2 asymptomatic. The etiology of the stenoses was atherosclerotic in all cases. Results: Angioplasty was performed in 8 of 11 V1 and 2 of 4 V4 segments of the VA. In 3 of 11 V1 segments and 2 of 4 V4 segments of the VA we combined angioplasty with stenting. The procedures were successfully performed in 14 of 16 VAs (87%). Complications were asymptomatic vessel dissection resulting in vessel occlusion in 1 of 11 V1 segments and asymptomatic vessel dissection in 2 of 4 V4 segments of the VA. One patient died in the 24-hr period after the procedure because of subarachnoid hemorrhage as a complication following vessel perforation of the treated V4 segment. Conclusion: Angioplasty or angioplasty and stenting of extracranial VA stenoses can be performed with a high technical success rate and a low complication rate. In intracranial VA stenosis the procedure is technically feasible but complications can be life-threatening. The durability and procedural complication rates of primary stenting without using predilation in extra- and intracranial VA stenosis should be defined in the future.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. PA Rasmussen J II Perl JD Barr GZ Markarian 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 Occurrence Handle1:STN:280:DC%2BD3c3lt1altg%3D%3D Occurrence Handle10794290

    CAS  PubMed  Google Scholar 

  2. TM Jr Sundt HC Smith JK Campbell RE Vliestra RF Cucchiara AW Stanson (1980) ArticleTitleTransluminal angioplasty for basilar artery stenosis. Mayo Clin Proc 55 673–680 Occurrence Handle7442321

    PubMed  Google Scholar 

  3. RT Higashida GB Hieshima FY Tsai et al. (1987) ArticleTitleTransluminal angioplasty of the vertebral and basilary artery. AJNR Am J Neuroradiol 8 745–749 Occurrence Handle1:STN:280:BieD2cnksFA%3D Occurrence Handle2960222

    CAS  PubMed  Google Scholar 

  4. 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

    CAS  PubMed  Google Scholar 

  5. JJ Connors III JC Wojak (1999) ArticleTitlePercutaneous transluminal angioplasty for intracranial atherosclerotic lesions: Evolution of technique and short-term results. J Neurosurg 91 415–423 Occurrence Handle10470816

    PubMed  Google Scholar 

  6. H Yokote T Terada K Ryujin Y Konoshita M Tsuura E Nakau J Kamei H Moriwaki S Hayashi T Itakura (1998) ArticleTitlePercutaneous transluminal angioplasty for intracranial arteriosclerotic lesions. Neuroradiology 40 590–596 Occurrence Handle10.1007/s002340050651 Occurrence Handle1:STN:280:DyaK1M%2FitlGjtg%3D%3D Occurrence Handle9808318

    Article  CAS  PubMed  Google Scholar 

  7. R Kachel St Basche I Heerklotz K Grossmann S Endler (1991) ArticleTitlePercutaneous transluminal angioplasty (PTA) of supra-aortic arteries especially the internal carotid artery. Neuroradiology 33 191–194 Occurrence Handle1:STN:280:By6A2M7ksVA%3D Occurrence Handle1831885

    CAS  PubMed  Google Scholar 

  8. HC Nahser H Henkes W Weber E Berg-Dammer TA Yousry D Kühne (2000) ArticleTitleIntracranial vertebrobasilar stenosis: angioplasty and follow-up. AJNR Am J Neuroradiol 21 1293–1301 Occurrence Handle1:STN:280:DC%2BD3M%2FotlOntQ%3D%3D Occurrence Handle10954282

    CAS  PubMed  Google Scholar 

  9. RT Higashida FY Tsai VV Halbach CF Dowd T Smith K Fraser GB Hieshima (1993) ArticleTitleTransluminal angioplasty for atherosclerotic disease of the vertebral and basilar arteries. J Neurosurg 78 192–198 Occurrence Handle1:STN:280:ByyC3s3ls1Q%3D Occurrence Handle8421202

    CAS  PubMed  Google Scholar 

  10. B George C Laurian (1982) ArticleTitleVertebro-basilar ischaemia: Its relation to stenosis and occlusion of the vertebral artery. Acta Neurochir (Wien) 62 287–295 Occurrence Handle1:STN:280:Bi2B2MzjvFY%3D

    CAS  Google Scholar 

  11. T Terada RT Higashida VV Halbach et al. (1996) ArticleTitleTransluminal angioplasty for arteriosclerotic disease of the distal vertebral and basilar arteries. J Neurol Neurosurg Psychiatry 60 377–381 Occurrence Handle1:STN:280:BymA2s%2FltVc%3D Occurrence Handle8774399

    CAS  PubMed  Google Scholar 

  12. M Piotin L Spelle J-B Martin A Weill G Rancurel IB Ross DA Rüfenacht J Chiras (2000) ArticleTitlePercutaneous transluminal angioplasty and stenting of the proximal vertebral artery for symptomatic stenosis. AJNR Am J Neuroradiol 21 727–731 Occurrence Handle1:STN:280:DC%2BD3c3kt1yrsg%3D%3D Occurrence Handle10782786

    CAS  PubMed  Google Scholar 

  13. 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. AJNR Am J Neuroradiol 21 249–254 Occurrence Handle1:STN:280:DC%2BD3c7lvVGmsw%3D%3D Occurrence Handle10696004

    CAS  PubMed  Google Scholar 

  14. AK Wakhloo FO Tio BB Lieber F Schellhammer M Graf N Hopkins (1995) ArticleTitleSelf-expanding nitinol stents in canine vertebral arteries: Hemodynamics and tissue response. AJNR Am J Neuroradiol 16 1043–1051 Occurrence Handle1:STN:280:ByqA28njsVw%3D Occurrence Handle7639126

    CAS  PubMed  Google Scholar 

  15. RA Koenigsberg A Dave D McCormick J Weiss RT Higashida SH Faro LM Grandinetti FY Tsai (2000) ArticleTitleComplicated stent supported cerebrovascular angioplasty: Case analyses and review of literature. Surg Neurol 53 465–474 Occurrence Handle10.1016/S0090-3019(00)00209-3 Occurrence Handle1:STN:280:DC%2BD3czjsVOltA%3D%3D Occurrence Handle10874146

    Article  CAS  PubMed  Google Scholar 

  16. GS Storey MP Marks M Dake AM Norbash GK Steinberg (1996) ArticleTitleVertebral artery stenting following percutaneous transluminal angioplasty. J Neurosurg 84 883–897 Occurrence Handle1:STN:280:BymC1MfptFM%3D Occurrence Handle8622166

    CAS  PubMed  Google Scholar 

  17. HD Chaistain II MS Campbell S Iyer GS Roubin J Vitek A Mathur NA Al-Mubarak JB Terry V Yates K Kretzler D Alred CR Gomez (1991) ArticleTitleExtracranial vertebral artery stent placement: In-hospital and follow-up results. J Neurosurg 91 547–552

    Google Scholar 

  18. AM Malek RT Higashida CC Phatourous TE Lempert PM Meyers DR Gress C Dowd VV Halbach (1999) ArticleTitleTreatment of posterior circulation ischemia with extracranial percutaneous balloon angioplasty and stent placement. Stroke 30 2073–2085 Occurrence Handle1:STN:280:DyaK1MvksVSjtg%3D%3D Occurrence Handle10512910

    CAS  PubMed  Google Scholar 

  19. RT Higashida FY Tsai VV Halbach CF Dowd GB Hieshima (1996) ArticleTitleTransluminal angioplasty, thrombolysis and stenting for extracranial and intracranial cerebral vascular disease. J Intervent Cardiol 9 245–255

    Google Scholar 

  20. KD Mathias U Kempkes A Mau HJ Jaeger (1993) ArticleTitleResults of internal carotid artery percutaneous transluminal angioplasty in 250 patients. 79th Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA 93), Chicago, USA. Radiology 190 622

    Google Scholar 

  21. HJ Jaeger KD Mathias R Drescher E Hauth G Bockisch E Demirel HM Gissler (2001) ArticleTitleDiffusion-weighted MR imaging after angioplasty or angioplasty plus stenting of arteries supplying the brain. AJNR Am J Neuroradiol 22 1251–1259 Occurrence Handle1:STN:280:DC%2BD3Mvlt1Slsg%3D%3D Occurrence Handle11498411

    CAS  PubMed  Google Scholar 

  22. AG Osborn (1999) The vertebrobasilar system. 2nd edn. . . (Eds) Diagnostic cerebral angiography Lippincott Williams and Wilkins Philadelphia 173–194

    Google Scholar 

  23. InstitutionalAuthorNameNorth American Symptomatic Carotid Endarterectomy Trial Collaborators (1991) ArticleTitleBeneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med 325 445–453 Occurrence Handle1852179

    PubMed  Google Scholar 

  24. JJ. Connors III (1999) Intracranial angioplasty. JJ Connors III JC Wojak (Eds) Interventional radiology: Strategies and practical techniques WB Saunders Philadelphia 500–555

    Google Scholar 

  25. W Hacke M Hennerici HJ Gelmers G Krämer (1991) Epidemiology and classification of strokes. W Hacke • Hennerici HJ Gelmers G Krämer (Eds) Cerebral ischemia Springer Berlin Heidelberg New York 31–52

    Google Scholar 

  26. W Hacke M Hennerici HJ Gelmers G Krämer (1991) Clinical syndromes, pathogenesis, and differential diagnosis. W Hacke • Hennerici HJ Gelmers G Krämer (Eds) Cerebral ischemia Springer Berlin Heidelberg New York 54–107

    Google Scholar 

  27. E Lang M Afilalo RS Krause (2001) ArticleTitleVertebrobasilar atherothrombotic disease. eMedicine J 2 1–14

    Google Scholar 

  28. InstitutionalAuthorNameThe Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Study Group (1998) ArticleTitlePrognosis of patients with symptomatic vertebral or basilar artery stenosis. Stroke 29 1389–1392

    Google Scholar 

  29. LN Hopkins JL Budny (1989) ArticleTitleComplications of intracranial bypass for vertebrobasilar insufficiency. J Neurosurg 70 207–211 Occurrence Handle1:STN:280:BiaC3M%2FktlQ%3D Occurrence Handle2643687

    CAS  PubMed  Google Scholar 

  30. R Berguer (1993) Long-term results of vertebral artery reconstruction. JST Yao WH Pearce (Eds) Long-term results in vascular surgery Appleton and Lange Norwalk, CT 69

    Google Scholar 

  31. JJ. Connors III (1999) Other extracranial locations amenable to angioplasty with stenting. JJ Connors III JC Wojak (Eds) Interventional radiology: Strategies and practical techniques WB Saunders Philadelphia 484–499

    Google Scholar 

  32. JJ Connors JC Wojak Z Qian (1999) Tools of the trade. JJ Connors III JC Wojak (Eds) Interventional radiology: Strategies and practical techniques WB Saunders Philadelphia 1–37

    Google Scholar 

  33. RR Makkar NL Eigler S Kaul et al. (1998) ArticleTitleEffects of clopidogrel, aspirin and combined therapy in a porcine ex vivo model of high-shear induced stent thrombosis. Eur Heart J 19 1538–1546 Occurrence Handle10.1053/euhj.1998.1042 Occurrence Handle1:CAS:528:DyaK1cXntlWlsL8%3D Occurrence Handle9820993

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology and Interventional Radiology, University Hospital Essen, Essen, Germany

    Elke A.M. Hauth

  2. Department of Radiology, Klinikum Dortmund, Dortmund, Germany

    Elke A.M. Hauth, H. Martin Gissler, Robert Drescher, Christian Jansen, Horst J. Jaeger & Klaus D. Mathias

Authors
  1. Elke A.M. Hauth
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. Martin Gissler
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robert Drescher
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christian Jansen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Horst J. Jaeger
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Klaus D. Mathias
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hauth, E., Gissler, H., Drescher, R. et al. Angioplasty or Stenting of Extra- and Intracranial Vertebral Artery Stenoses . CVIR 27, 51–57 (2004). https://doi.org/10.1007/s00270-003-0028-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-003-0028-7

Keywords

Search

Navigation