[Percutaneous transluminal angioplasty of bilateral vertebral arteries: case report]

A 58-year-old female suffered frequent attacks of unconsciousness due to vertebrobasilar insufficiency. She had a slight left hemiparesis, dysarthria, gait disturbance, and decreased vibration sense. Angiography revealed remarkable stenoses of the bilateral vertebral artery origin with inadequate collateral flow from the anterior circulation. Percutaneous transluminal angioplasty (PTA) was performed on the more severely narrowed left vertebral artery through transfemoral approach. This was followed by PTA on the right one through transbrachial approach after an interval of 3 weeks. The procedure cleared off the signs and symptoms; neuroradiological studies including angiography and Xe-CT scan confirmed the improvement. PTA has been performed on stenotic lesions at the origin of the vertebral artery and the common carotid artery with more safety than on stenotic lesions of the other cerebral arteries, because of the smooth luminal non-ulcerated lesions of the former. In spite of the possibility of restenosis after PTA, in selected cases, PTA leads to good results, less complications and shorter stay in hospital. These factors are of major benefit to the patients. In the future, PTA may be an alternative method for treating arterial stenotic lesions in the field of neurosurgery.