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Stent-assisted angioplasty for intracranial atherosclerosis
Toshinori Nakahara1, Shigeyuki Sakamoto, Osamu Hamasaki
1Division of Neuroendovascular Treatment, Mazda Hospital, 2-15, Aosakiminami, Fuchu-cho Aki-gun, Hiroshima, 735-0017 Japan. tnakahar@iwa.att.ne.jp
Insights
Stent-assisted angioplasty effectively treated severe intracranial atherosclerosis in two patients unresponsive to medical therapy. The procedure demonstrated safety and efficacy, with patients remaining symptom-free post-treatment.
Area of Science:
- Neurology
- Interventional Cardiology
- Vascular Surgery
Background:
- Intracranial atherosclerosis poses a significant risk for stroke.
- Severe cases often present with refractory symptoms despite optimal medical management.
- Treatment options for symptomatic intracranial stenosis remain limited.
Observation:
- Two patients with severe (>70%) intracranial atherosclerosis of the carotid or vertebral arteries were treated.
- Both patients had persistent symptoms despite maximal medical therapy.
- A coronary balloon-expandable stent was deployed using a protective balloon technique.
Findings:
- The stent-assisted angioplasty procedure was technically successful in both patients.
- No procedural complications were observed.
- Patients remained asymptomatic and neurologically intact at a mean follow-up of 13 months.
- Follow-up angiograms at 3 and 4 months showed no evidence of restenosis.
Implications:
- Stent-assisted angioplasty is a safe and effective treatment for selected patients with symptomatic intracranial atherosclerosis.
- This technique offers a viable option for patients refractory to medical treatment.
- The procedure shows promise for reducing stroke risk and improving neurological outcomes.
Abstract:
We report on two patients with intracranial atherosclerosis of the carotid artery or vertebral artery treated with stent-assisted angioplasty. Both patients have severe intracranial atherosclerosis (>70%) with refractory symptoms despite optimal medical treatment. In both patients, a coronary balloon-expandable stent was successfully placed using a protective balloon technique without procedural complications. The patients were asymptomatic and neurologically intact at a mean clinical follow-up of 13 months. Follow-up angiograms did not show restenosis 3 or 4 months after procedure, respectively. Stent-assisted angioplasty for intracranial atherosclerosis in the elective patient has proven effective, with an acceptable low rate of morbidity and mortality.