Percutaneous Transluminal Angioplasty and Stenting of Midbasilar Stenoses: Three Technical Case Reports and Literature Review

Percutaneous Transluminal Angioplasty and Stenting of Midbasilar Stenoses: Three Technical Case... AbstractOBJECTIVESymptomatic basilar artery stenosis is a highly morbid disease process. Recent technological and pharmaceutical advances make endovascular treatment of this disease process possible.CLINICAL PRESENTATIONWe report three cases of patients with a symptomatic basilar artery stenosis despite anticoagulation.INTERVENTIONAll patients were successfully treated with a flexible coronary stent and perioperative antiplatelet medications without incident. Poststenting angiography demonstrated a normal-caliber artery with patent perforators. In one case, a poststenting cerebral blood flow study revealed improved perfusion.CONCLUSIONA new generation of stents and balloons makes access to intracranial intradural arterial pathological abnormalities possible. Such devices may well revolutionize the management of ischemic and hemorrhagic intracranial cerebrovascular disease. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Percutaneous Transluminal Angioplasty and Stenting of Midbasilar Stenoses: Three Technical Case Reports and Literature Review

Percutaneous Transluminal Angioplasty and Stenting of Midbasilar Stenoses: Three Technical Case Reports and Literature Review

Angioplasty and Stenting of Midbasilar Stenoses 925 Percutaneous Transluminal Angioplasty and Stenting of Midbasilar Stenoses: Three Technical Case Reports and Literature Review Michael B. H o r o w itz , M . D . , G . L e e P rid e , M . D . , Dion F. G ra y b e a l, M . D . , P h illip D . P u rd y , M . D . Departments of Neurosurgery (M BH, PDP), Radiology (MBH, CLP, PDP), and Neurology (DFC), University of Texas Southwestern Medical Center, Dallas, Texas OBJECTIVE AND IM PO R T A N C E: Symptomatic basilar artery stenosis is a FIGURE 2. Left vertebral artery a rte ­ highly morbid disease process. Recent technological and pharmaceutical riogram demonstrating p retreatm en t basilar stenosis. advances make endovascular treatment of this disease process possible. CLINICAL PRESENTATIO N: W e report three cases of patients with a symp­ patient subsequently experienced occa­ tomatic basilar artery stenosis despite anticoagulation. sional dysarthria, difficulty with short­ INTERVENTION: All patients were successfully treated with a flexible cor­ term memory, and worsening ataxia, de­ onary stent and perioperative antiplatelet medications without incident. spite treatment with 325 mg aspirin/d Poststenting angiography demonstrated a normal-caliber artery with and warfarin with documented interna­ patent perforators. In one case, a poststenting cerebral blood flow study tional normalized ratio values of 3 for 2 revealed improved perfusion. months. His neurological examination CONCLUSION: A new generation of stents and balloons makes access to was remarkable for a slightly wide-based intracranial intradural arterial pathological abnormalities possible. Such de­ gait, subtle dysarthria, and slight right­ sided dysmetria. vices may well revolutionize the management of ischemic and hemorrhagic intracranial cerebrovascular disease. (Neurosurgery 45:925-931, 1999) P ro ced u re keywords: Basilar artery, Stenosis, Stent The patient was...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199910000-00043
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVESymptomatic basilar artery stenosis is a highly morbid disease process. Recent technological and pharmaceutical advances make endovascular treatment of this disease process possible.CLINICAL PRESENTATIONWe report three cases of patients with a symptomatic basilar artery stenosis despite anticoagulation.INTERVENTIONAll patients were successfully treated with a flexible coronary stent and perioperative antiplatelet medications without incident. Poststenting angiography demonstrated a normal-caliber artery with patent perforators. In one case, a poststenting cerebral blood flow study revealed improved perfusion.CONCLUSIONA new generation of stents and balloons makes access to intracranial intradural arterial pathological abnormalities possible. Such devices may well revolutionize the management of ischemic and hemorrhagic intracranial cerebrovascular disease.

Journal

NeurosurgeryOxford University Press

Published: Oct 1, 1999

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