Intravascular ultrasound for intracranial angioplasty and stent placement: Technical case report

J. Christopher Wehman, David Holmes, Ricardo A. Hanel, Elad I. Levy, L. Nelson Hopkins

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

OBJECTIVE: Intravascular ultrasound (IVUS) imaging has been used extensively in coronary artery interventions and has provided invaluable information for the understanding and treatment of coronary arterial disease. We present here the first description, to our knowledge, of IVUS-guided intracranial arterial interventions in the clinical setting. CLINICAL PRESENTATION: Two patients underwent intracranial angioplasty and stent placement with the assistance of IVUS for the evaluation of their lesions. One patient underwent stenting to treat an occlusive dissection of the left internal carotid artery that occurred during arteriovenous malformation embolization. Another patient underwent angioplasty and stenting for high-grade restenosis of a basilar artery atherosclerotic lesion. RESULTS: Both patients underwent successful revascularization procedures. The patient with the dissection had a small intraventricular and parenchymal hemorrhage documented by computed tomography 4 hours after treatment, but did not develop hydrocephalus or further hemorrhage. Both patients did well clinically and had no permanent neurological deficits. IVUS provided important information in terms of lesion evaluation, stent selection, and stent placement in each case. CONCLUSION: IVUS of the intracranial circulation may assist the performance of intracranial angioplasty and stenting. It provides useful information that can affect clinical decisions. It may prove to be a valuable tool in clinical use and enhance our understanding of vascular disease of the intracranial circulation, as it has in the coronary circulation.

Original languageEnglish (US)
JournalNeurosurgery
Volume59
Issue number4 SUPPL. 2
DOIs
StatePublished - Oct 1 2006

Fingerprint

Angioplasty
Stents
Internal Carotid Artery Dissection
Hemorrhage
Cerebrovascular Disorders
Coronary Circulation
Basilar Artery
Arteriovenous Malformations
Hydrocephalus
Coronary Disease
Dissection
Ultrasonography
Coronary Vessels
Tomography
Therapeutics

Keywords

  • Arterial dissection
  • Intracranial atherosclerosis
  • Intravascular ultrasound
  • Stents

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Intravascular ultrasound for intracranial angioplasty and stent placement : Technical case report. / Wehman, J. Christopher; Holmes, David; Hanel, Ricardo A.; Levy, Elad I.; Hopkins, L. Nelson.

In: Neurosurgery, Vol. 59, No. 4 SUPPL. 2, 01.10.2006.

Research output: Contribution to journalArticle

Wehman, J. Christopher ; Holmes, David ; Hanel, Ricardo A. ; Levy, Elad I. ; Hopkins, L. Nelson. / Intravascular ultrasound for intracranial angioplasty and stent placement : Technical case report. In: Neurosurgery. 2006 ; Vol. 59, No. 4 SUPPL. 2.
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