Successful percutaneous transluminal angioplasty for basilar artery stenosis: technical case report

We report our experience with low-pressure submaximal percutaneous transluminal angioplasty (PTA) for basilar artery stenosis of > 90%. This treatment resulted in a favorable clinical course and satisfactory improvement of posterior cerebral circulation.

This technique was applied to two patients with repeated basilar arterial ischemic symptoms that were resistant to medical treatment.

Low-pressure submaximal PTA was performed with use of a smaller balloon (2.0-mm diameter) and lower inflation pressure (< or = 303,975 Pa) than previously reported.

Despite basilar arteries with 50 and 60% residual stenosis, the clinical symptoms and hemodynamics in the basilar arterial territory as assessed using single photon emission tomography were markedly improved after PTA. Follow-up angiographic evaluation demonstrated the absence of restenosis, and improved cerebral blood flow was maintained. Neither patient has developed any new neurological deficits 10 and 13 months after the PTA, respectively.

Submaximal PTA may have reduced the high risk associated with this procedure, and cerebral blood flow measurement may be a useful tool to assess whether this technique will produce adequate results.