[Endovascular treatment of critical basilar stenosis with a Solitaire® stent device: a first experience in our...

Area of Science:

• Neurology
• Interventional Neuroradiology
• Vascular Surgery

Background:

• Intracranial arteriosclerosis is a significant stroke risk factor, with treatment strategies still evolving.
• The SAMMPRIS trial suggested medical management superiority over stenting for intracranial stenosis, potentially influenced by specific devices like the Wingspan® stent.
• Optimal treatment for severe, symptomatic basilar artery stenosis remains a clinical challenge.

Observation:

• A 71-year-old male presented with recurrent transient neurological deficits despite antiplatelet and statin therapy for severe basilar artery stenosis.
• Endovascular intervention with angioplasty and Solitaire® stent placement was performed due to the patient's refractory symptoms.
• The procedure resulted in a residual stenosis of 40% and was technically successful.

Findings:

• The patient experienced a favorable clinical outcome post-procedure, with minimal progression noted on follow-up imaging.
• This represents the first reported case of critical basilar artery stenosis treated with a Solitaire® stent.

Implications:

• The Solitaire® stent may be a viable treatment option for select cases of severe intracranial stenosis, particularly in the basilar artery.
• Further research is warranted to evaluate the long-term efficacy and safety of the Solitaire® stent in intracranial arteriosclerosis.
• This case highlights the potential of endovascular techniques in managing complex cerebrovascular diseases.