Percutaneous transluminal angioplasty for intracranial vertebral and/or basilar artery stenosis

Abstract

OBJECTIVE: Despite the growing clinical use of percutaneous transluminal angioplasty (PTA) for atherosclerotic lesions, application of this technique for intracranial vertebral and/or basilar arteries is not common. In this report, we present our experience with PTA for intracranial vertebrobasilar systems and assess its usefulness. PATIENTS AND METHODS: We report our experiences with PTA in six steno-occlusive lesions affecting intracranial vertebral and/or basilar arteries in five patients. One of the two patients with acute stroke had involvement of both the vertebral and basilar arteries, and the other had involvement of the dominant vertebral artery. In two of the other three patients, without acute stroke, the intracranial vertebral arteries were involved and in one the basilar artery was involved, but the symptoms were unresponsive to intensive medical therapy. PTA was performed for these lesions without complications and the clinical symptoms improved. During the procedure, we took care not to overdilate the lesions. RESULTS: These lesions were treated by PTA without complications and the clinical symptoms improved. CONCLUSION: The authors' experience suggests that PTA might be an effective therapy for stenoses of the intracranial vertebral and/or basilar arteries. In patients with acute stroke where there is not enough time for surgical treatment, emergency PTA is useful and improves the clinical symptoms. Further study is needed to confirm its long-term effectiveness for symptomatic stenosis of vertebrobasilar systems.