Coaxial double catheter technique in intracranial posterior circulation stenting

Gangming XI; Wei WANG

ABSTRACT

BACKGROUND:

The posterior circulation artery is characterized by small caliber, long traveling, many curves and branches, so a stronger resistance will be encountered when a stent is delivered.

OBJECTIVE:

To investigate the effects of coaxial double catheter technique on intracranial posterior circulation stenting.DESIGN, TIME AND

SETTING:

A retrospective case analysis was performed at the Department of Neurology, Affiliated People's Hospital of Yunyang Medical College between December 2004 and February 2008.

PARTICIPANTS:

A total of 21 patients, 11 males and 10 females, aged 50-76 years old, were se/ected from the Department of Neurology, Affiliated People's Hospital of Yunyang Medical College.

METHODS:

All patients were confirmed as posterior circulation intracranial stenosis (stenosis > 70%) by digital subtraction angiography (DSA), magnetic resonance angiography (MRA), or CT angiography (CTA). They underwent cerebrovascular stent implantation, during which, single catheter technique was first applied, if failed, a coaxial double catheter technique was followed. A conventional group (single catheter technique successfully applied) and a double catheter group (coaxial double catheter technique successfully employed) were set. A written informed consent was obtained from each patient.MAIN OUTCOME

MEASURES:

Therapeutic results and biocompatibility of implanted stents.

RESULTS:

The single catheter technique was applied in 21 patients and 6 of them (28.57%) had successful stent deployment, The remaining 15 patients were managed by a coaxial double catheter technique, and the stent was successfully released in these patients. There was only 1 patient presenting with subarachnoid hemorrhage, and the success rate of stent deployment was 93.33%. Chi-square tests results showed that the coaxial double catheter technique produced significantly higher success rate of stent implantation than the single catheter technique (P < 0.05). Except this, no other adverse reactions were found. All stents covered the stenosis lesions completely, and fitted well with the blood vessel wall without rejection, showing the good biocompatibility of selected stents with the host.

CONCLUSION:

The coaxial double catheter technique can increase the longitudinal supporting strength and enhance the success rate of the intracranial posterior circulation stenting. Meanwhile, the risks of this procedure are low. Therefore, the technique deserves to be popularized.