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Tenzingplasty for symptomatic, non-occlusive intracranial atherosclerotic disease after maximal medical therapy

Faraz Behzadi1, Cameron M McDougall2, Neehar Gaddam3

  • 1Department of Neurology; University of Arizona College of Medicine, Phoenix, US.

Journal of Cerebrovascular and Endovascular Neurosurgery
|March 4, 2026
PubMed

Insights

The Tenzing angioplasty technique (T-Plasty) offers a safe and effective option for treating intracranial atherosclerotic disease (ICAD) without large vessel occlusion (LVO), improving patient outcomes and reducing stroke severity.

Area of Science:

  • Neurology
  • Interventional Neuroradiology
  • Vascular Surgery

Background:

  • Intracranial atherosclerotic disease (ICAD) is a significant cause of ischemic stroke.
  • Traditional balloon angioplasty for ICAD carries a high complication rate.
  • The Tenzing support catheter, initially designed for large vessel occlusion (LVO) stroke, shows potential for ICAD treatment.

Purpose of the Study:

  • To evaluate the safety and efficacy of the Tenzing angioplasty technique (T-Plasty) for treating ICAD in the absence of LVO.
  • To assess neurological outcome improvements and complication rates associated with T-Plasty for ICAD.

Main Methods:

  • A prospectively maintained database of adult ICAD patients without LVO treated with T-Plasty was reviewed.
  • Data collected included demographics, procedural details, and clinical outcomes using NIHSS and mRS.
  • Statistical analysis, including Student's T-test, was employed to assess significance.

Main Results:

  • 18 adult patients with symptomatic ICAD (no LVO) underwent T-Plasty between September 2024 and April 2025.
  • All patients demonstrated improvement, with an average NIHSS reduction of 4.5 points and mRS improvement of nearly 1 point.
  • No operative or post-operative complications were observed within 30-day follow-up.

Conclusions:

  • T-Plasty is a viable option for the elective treatment of chronic symptomatic ICAD.
  • This technique can also be beneficial for acute hypoperfusion syndrome secondary to ICAD.
  • T-Plasty demonstrates potential for improving neurological outcomes in ICAD patients.
Abstract

Keywords:
AngioplastyCerebral arteriosclerosisEndovascular proceduresStrokeTenzingplasty

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