Recurrent Abrupt Occlusion after Transluminal Angioplasty for Basilar Artery Stenosis: Case Report

Recurrent Abrupt Occlusion after Transluminal Angioplasty for Basilar Artery Stenosis: Case Report AbstractOBJECTIVE AND IMPORTANCEAngioplasty for basilar artery stenosis is often complicated by recurrent abrupt vessel closure. The clinical results can be catastrophic. In this case report, we assess the effects of intra-arterial papaverine (American Regent Laboratories Inc., Shirley, NJ) on rebound occlusionCLINICAL PRESENTATIONThe patient presented with crescendo transient ischemic attacks from atherosclerotic narrowing of the midhasilar artery despite maximal medical treatment.INTERVENTIONAngioplasty of the midbasilar artery was performed with serial balloon inflations. The patient was treated successfully with intra- arterial papaverine and achieved a nearly full recovery, with only mild dysarthria, by the time of the 7-month follow-up examination.CONCLUSIONUsing intra-arterial papaverine, we were able to reverse the effects of this potentially life-threatening complication of basilar artery angioplasty. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Recurrent Abrupt Occlusion after Transluminal Angioplasty for Basilar Artery Stenosis: Case Report

Recurrent Abrupt Occlusion after Transluminal Angioplasty for Basilar Artery Stenosis: Case Report

210 Jimenez et al F I G U R E 1. Right Recurrent Abrupt Occlusion after vertebral arteriogram Transluminal Angioplasty for Basilar show ing a tight e c c e n tric stenosis Artery Stenosis: Case Report at the midbasilar r level (arrowhead) * and occlusion of the distal left vertebral artery just Carlos Jimenez, M .D ., Hoang Duong, M .D ., below the verteb ro b asilar junction Marcelo Olarte, M .D ., John Pile-Spellman, M .D. (arrow). Servicio de Neurocirugia (CJ), Hospital Universitario San Vincente de Paul, Medellin, Colombia, and Departments of Radiology (HD, JP-S) and Neurology (M O), Columbia patient w as m on itored in the neurolog- r University, New York, New York ical intensive care unit and received va- * so p ressors to m ain tain adequate perfu- = sion across the b asilar artery stenosis : Follow -u p M R im a g in g / M R angiogra-■ OBJECTIVE A N D IM PORTANCE: Angioplasty for basilar artery stenosis is often phy p erform ed 1 w e e k later revealed * complicated by recurrent abrupt vessel closure. The clinical results can be w o rse n in g of the m id b asilar stenosis catastrophic. In this case report, we assess the effects of intra-arterial papav­ and h v p e rin ten se foci on T2-weighted ^ erine (American Regent Laboratories Inc., Shirley, NJ) on rebound occlusion. se q u en ces in the u p p er pons and the ^ C L IN IC A L PR ESEN TA TIO N : The patient presented with crescendo transient right cereb ellar h e m isp h e re , which were ^ ischemic attacks from atherosclerotic narrowing of the midhasilar artery interpreted as new infarcts (Fig. 2). At despite maximal medical treatment. that point, the d ecision w as made to 3 offer an g io p la sty to p rev en t a major j IN T E R V E N T IO N : Angioplasty of the midbasilar artery was performed with brain stem infarct. serial balloon inflations. The patient was treated successfully with intra- W ith the p atien t u n d er general anes-■ arterial papaverine and achieved a nearly full...
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Publisher
Oxford University Press
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199901000-00127
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVE AND IMPORTANCEAngioplasty for basilar artery stenosis is often complicated by recurrent abrupt vessel closure. The clinical results can be catastrophic. In this case report, we assess the effects of intra-arterial papaverine (American Regent Laboratories Inc., Shirley, NJ) on rebound occlusionCLINICAL PRESENTATIONThe patient presented with crescendo transient ischemic attacks from atherosclerotic narrowing of the midhasilar artery despite maximal medical treatment.INTERVENTIONAngioplasty of the midbasilar artery was performed with serial balloon inflations. The patient was treated successfully with intra- arterial papaverine and achieved a nearly full recovery, with only mild dysarthria, by the time of the 7-month follow-up examination.CONCLUSIONUsing intra-arterial papaverine, we were able to reverse the effects of this potentially life-threatening complication of basilar artery angioplasty.

Journal

NeurosurgeryOxford University Press

Published: Jan 1, 1999

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