Percutaneous transluminal angioplasty and stenting for symptomatic intracranial atherosclerotic stenosis

Abstract

Objective To evaluate the safety, efficacy, and short ⁃ and medium ⁃ term effect of percutaneous transluminal angioplasty and stenting (PTAS) for symptomatic intracranial atherosclerotic stenosis. Methods Twenty ⁃ four patients with intracranial artery stenosis were treated by PTAS. Six lesions were detected at intracranial segment of internal carotid artery (ICA), 7 at middle cerebral artery (MCA), and 11 at intracranial segment of vertebrobasilar artery. Among them, 22 Wingspan stents were implanted. Two cases were successfully treated by Gateway balloon without stenting. Two cases with vertebrobasilar artery stenosis were implanted with Apollo and Invastent Volo balloon stents, respectively. Results After treatment the stenosis rate in 24 patients was reduced from 60%-95% to 0-20% . The follow ⁃up period of 23 patients was 2-24 months. The efficancy was satisfactory, and no recurrent was seen. There were 2 patients occurred cerebral hemorrhage after implanted Wingspan stents 1-3 h later, one patient died and one patient presented hemiparalysis. The mortality and disability rate was 8.33% . Conclusion Percutaneous transluminal angioplasty and stenting for symptomatic inracranial artery stenosis is effective. The short⁃ and medium⁃term effect is good. Although having strict entry⁃standards, Gateway balloon⁃Wingspan stent system still emerge serious complications, which should be paid with close attention.

DOI：10.3969/j.issn.1672-6731.2010.05.012