Transluminal angioplasty and stenting for the intracranial and extracranial cerebral arterial stenosis: Preliminary experiences

ABSTRACT

PURPOSE: To report the preliminary results of percutaneous transluminal balloon angioplasty (PTA) and stenting for the intracranial or extracranial care bral arterial stenosis. METHODS: In 11 patient% a total of 12 hemodynamically significant arterial stenatic lesions were treated by tramluminal angioplasty with or without the we of stent ; 8 proiml internal carotid arteries (ICA), 2 middle cerebral arteries (MCA), I distal vertebral artery (VA) and I proximal VA. We performed stent placement for 7 ICA lesions, while we did PTA alone for 2 MCA stenoses. PTA for 1 ICA and 2 VA lesions was performed while we attempted intraarterial urokinam (IAUK) therapy. RESULTS: Mean residual stenosis measured immediately after the procedure was 7% (range 0-27%) in 7 ICA lesions (treated by slanting), 13% and 29% in 2 MCA lesions (PTA), and 38% (range 32 41%) in 1 ICA and 2 VA lesions (PTA after IALJK). During and immediately after the procedure, 2 patients with ICA stenwis developed a transient ischemic attack (TIA) and one patient with ICA stenosis showed the infarct progression. Two patients, who were treated by PTA during IAUK therapy, expired. During the follow-up period (range, 4-18 months; mean, 8.6 months), all patients but one with the MCA lesion were free from further ischemic events. CONCLUSIONS: The efficacy and safety of PTA and stenting were not sufficiently verified with the small number of cases in our series. However, our observations suggest that they may be used as an alternative treatment modality to endarterectomy or a new promising therapy for the extracranial or intracranial arterial stenosis.