Endovascular Stenting of an Acutely Thrombosed Basilar Artery: Technical Case Report and Review of the Literature

Endovascular Stenting of an Acutely Thrombosed Basilar Artery: Technical Case Report and Review... AbstractOBJECTIVE AND IMPORTANCE:The goal of this report was to describe the successful percutaneous endovascular use of a Gianturco-Roubin-2 coronary stent in the treatment of an acute atherothrombotic occlusion of the basilar artery. To our knowledge, the percutaneous endovascular deployment of an intra-arterial stent for the treatment of an acute atherothrombotic occlusion of the basilar artery and the percutaneous endovascular placement of a Gianturco-Roubin-2 stent in the basilar artery have not been previously reported.CLINICAL PRESENTATION:An 83-year-old man presented with a recurrent, transient, locked-in syndrome resulting from a lower basilar artery occlusion caused by vertebrobasilar thrombosis superimposed on severe proximal basilar artery atheromatous stenosis.INTERVENTION:After successful superselective intra-arterial thrombolysis of the vertebrobasilar clot, balloon angioplasty of the underlying basilar artery stenosis was performed, without significant angiographic improvement. Percutaneous endovascular deployment of a Gianturco-Roubin-2 coronary stent of 4-mm diameter was subsequently performed, with excellent angiographic results.CONCLUSION:The patient made a very good neurological recovery but unfortunately died as a result of cardiogenic shock and sepsis. Detailed neuropathological follow-up results are presented; stent patency was revealed in the postmortem examination. The anatomic and pathophysiological considerations of basilar artery stent placement for the treatment of acute basilar artery occlusion related to atherosclerotic stenosis 3re discussed. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Endovascular Stenting of an Acutely Thrombosed Basilar Artery: Technical Case Report and Review of the Literature

Endovascular Stenting of an Acutely Thrombosed Basilar Artery: Technical Case Report and Review of the Literature

usually initially treated m edically using Endovascular Stenting of an Acutely antiplatelet agents an d / or a n tico a g u la ­ tion therapy. For the subset of patients Thrombosed Basilar Artery: Technical for w hom medical m a n a g e m e n t fails and for those w ho present with basilar Case Report and Review of the Literature artery occlusion as an em erg en cy , the therapeutic options are limited. The re­ sults of surgical bypass grafting for b a si­ lar artery n arro w in g or occlusion are Constantine C. Phatouros, M .B.B.S., F.R.A.C.R., disap p ointing (25), especially if the Randall T. Higashida, M.D., Adel M. Malek, M.D., Ph.D., grafting is perform ed during an episode Wade S. Smith, M.D., Ph.D., Thaddeus W . Mully, M.D., of ischemia. Successful translum inal a n ­ gioplasty of the basilar artery w as first Stephen J. DeArmond, M.D., Ph.D., reported in 1980 by Su n d t et al. (25); Christopher F. Dowd, M.D., Van V. Fialbach, M.D. how ever, the bod y of data rem ains Department of Radiology, Division of Interventional Neurovascular Radiology (CCP, RTH, small. W hen angiop lasty is unsuccessful AMM, CFD, W H ) , and Departments of Neurological Surgery (RTH, CFD, W H ) , Neurology in relieving stenosis, the treatm ent o p ­ (WSS), and Neuropathology (T W M , S)D), University of California San Francisco Medical tions are essentially exhausted. E n d o ­ Center, San Francisco, California vascular stent p lacem ent has been su c ­ cessfully used in the treatm ent of a th erom atou s plaque in the coronary and peripheral arteries, and a recent re­ OBJECTIVE AND IMPORTANCE: The goal of this report was to describe the port described the first successful p ercu ­ successful percutaneous endovascular use of a Gianturco-Roubin-2 cor­ taneous en d o vascu lar d ep lo y m e n t of a onary stent in the treatment of an acute atherothrombotic occlusion of stent within the basilar artery (15). W e the basilar artery. To our...
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Publisher
Oxford University Press
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199903000-00134
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVE AND IMPORTANCE:The goal of this report was to describe the successful percutaneous endovascular use of a Gianturco-Roubin-2 coronary stent in the treatment of an acute atherothrombotic occlusion of the basilar artery. To our knowledge, the percutaneous endovascular deployment of an intra-arterial stent for the treatment of an acute atherothrombotic occlusion of the basilar artery and the percutaneous endovascular placement of a Gianturco-Roubin-2 stent in the basilar artery have not been previously reported.CLINICAL PRESENTATION:An 83-year-old man presented with a recurrent, transient, locked-in syndrome resulting from a lower basilar artery occlusion caused by vertebrobasilar thrombosis superimposed on severe proximal basilar artery atheromatous stenosis.INTERVENTION:After successful superselective intra-arterial thrombolysis of the vertebrobasilar clot, balloon angioplasty of the underlying basilar artery stenosis was performed, without significant angiographic improvement. Percutaneous endovascular deployment of a Gianturco-Roubin-2 coronary stent of 4-mm diameter was subsequently performed, with excellent angiographic results.CONCLUSION:The patient made a very good neurological recovery but unfortunately died as a result of cardiogenic shock and sepsis. Detailed neuropathological follow-up results are presented; stent patency was revealed in the postmortem examination. The anatomic and pathophysiological considerations of basilar artery stent placement for the treatment of acute basilar artery occlusion related to atherosclerotic stenosis 3re discussed.

Journal

NeurosurgeryOxford University Press

Published: Mar 1, 1999

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