Related Experiment Video
Updated: Jun 4, 2026
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Concurrent stenting of multiple cerebrovascular stenotic lesions: technical note
R W Crowley1, R Medel, A J Evans
1Department of Neurological Surgery, University of Virginia School of Medicine, Charlottesville, VA 22908, USA. rc9dd@virginia.edu
Insights
Treating multiple intracranial atherosclerosis lesions in one session with angioplasty and stenting is safe and effective. This approach avoids risks from repeated cerebral angiograms for patients with complex cerebrovascular disease.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Vascular Surgery
Background:
- Intracranial atherosclerosis treatment was historically limited.
- Endovascular techniques like angioplasty and stenting are now accepted for medically-refractory cases.
- Patients often present with multiple lesions of unclear individual significance.
Observation:
- A single patient case is presented focusing on clinical decision-making.
- Three distinct atherosclerotic lesions within the same vascular territory were treated.
- All lesions underwent angioplasty and stent placement in a single session.
Findings:
- Simultaneous endovascular treatment of multiple intracranial lesions is feasible.
- The technique appears safe and effective for complex intracranial atherosclerosis.
- This approach potentially reduces procedural risks compared to staged treatments.
Implications:
- This strategy may offer a safer alternative for managing complex intracranial atherosclerosis.
- It potentially minimizes patient exposure to multiple angiographic procedures.
- Further studies are warranted to confirm the long-term efficacy and safety of this technique.
Introduction:
Until recently, the treatment of intracranial atherosclerosis has remained limited. Due to advances in endovascular technology and technique, angioplasty and stenting has become an accepted treatment for medically-refractory intracranial atherosclerosis. Patients with intracranial atherosclerosis frequently have multiple lesions, however, the clinical significance of each individual lesion is not always evident. In these instances the treating physician must decide which lesions should be managed conservatively, and which should be treated.
Technique:
Emphasizing decision-making, we describe a patient in whom 3 separate atherosclerotic lesions in the same vascular territory underwent endovascular treatment in one treatment session. Each of the lesions was treated with angioplasty and stent placement.
Conclusion:
This may be a relatively safe and efficacious technique that allows for the treatment of multiple lesions without the risks associated with multiple cerebral angiograms.