Angioplasty and stenting of basilar artery stenosis: Technical case report

Giuseppe Lanzino, Richard D. Fessier, Robert S. Miletich, Lee R. Guterman, L. Nelson Hopkins

Research output: Contribution to journalArticlepeer-review

64 Scopus citations

Abstract

OBJECTIVE AND IMPORTANCE: Symptomatic basilar artery stenosis has a poor prognosis. Treatment options are limited. Surgical bypasses are technically demanding and of no proven benefit. Percutaneous angioplasty is associated with a significant complication rate, because of intraplaque dissection, restenosis secondary to vessel recoil, and embolic phenomena. A new generation of intravascular stents that are flexible enough to navigate the tortuosities of the vertebral artery may provide a new therapeutic approach. We report a case of basilar artery stenosis that was treated using stent- assisted angioplasty. CLINICAL PRESENTATION: A 56-year-old woman experienced a vertebrobasilar ischemic stroke, from which she recovered. Magnetic resonance angiography revealed severe proximal basilar artery stenosis. Brain Neurolite-single-photon emission computed tomographic scans revealed significantly decreased perfusion of the brainstem. Endovascular intra- arterial pressure measurements revealed a 35-mm Hg gradient across the lesion. INTERVENTION: The patient underwent uncomplicated angioplasty and stenting of the proximal basilar artery, with excellent angiographic results. CONCLUSION: The availability of new flexible intravascular stents, allowing access to tortuous proximal intracranial vessels, provides a new therapeutic approach for patients with basilar artery stenosis. Long-term follow-up monitoring is required to assess the durability of this approach.

Original languageEnglish (US)
Pages (from-to)404-408
Number of pages5
JournalNeurosurgery
Volume45
Issue number2
DOIs
StatePublished - Aug 1 1999

Keywords

  • Basilar artery stenosis
  • Brain single-photon emission computed tomographic scan
  • Intravascular stents
  • Percutaneous angioplasty

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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