title: Safety and efficacy of percutaneous transluminal angioplasty for intracranial atherosclerotic stenosis.
abstract: OBJECTIVE
  Percutaneous transluminal angioplasty (PCTA) is increasingly used to treat extracerebral arterial stenosis. The present study evaluates the safety and efficacy of PCTA treatment of symptomatic intracranial atherosclerotic stenosis.
  
  
  METHODS
  A series of 22 vessels in 17 patients were treated with PCTA. All patients had recurrent neurological symptoms referable to the stenotic vessel despite optimal medical therapy. Critical (> 70%) arterial stenosis was confirmed by angiogram, and angioplasty was performed with a 3.0- to 3.5-mm Stealth balloon.
  
  
  RESULTS
  The average preangioplasty stenosis (North American Symptomatic Carotid Endarterectomy Trial criteria) was 72 +/- 8% (mean +/- SD), with a significant improvement seen after angioplasty; the best angiographic stenosis (after healing of intimal injury, if any) was 43 +/- 24% (P < .001). Overall PCTA was successful in 82% of the vessels. There were two strokes during angioplasty for a 30-day morbidity rate of 9.1% per treated vessel and 11.7% per case. The other 15 patients were clinically evaluated at 3 and 6 months; all cases were without further events. Restenosis was evaluated in 8 patients (12 vessels) with an angiogram at 6 months showing further improvement compared with the initial post-PCTA stenosis (51 +/- 10% versus 37 +/- 21% [P = .05]).
  
  
  CONCLUSIONS
  PCTA may be a beneficial therapy in selected cases of symptomatic intracranial atherosclerotic stenosis. Further study using a randomized trial is needed.
authors.affiliation: Oregon Stroke Center, Department of Neurology, Oregon Health Sciences University, OR 97201, USA.
authors.forename: W M
authors.initials: WM
authors.lastname: Clark
authors.forename: S L
authors.initials: SL
authors.lastname: Barnwell
authors.forename: G
authors.initials: G
authors.lastname: Nesbit
authors.forename: O R
authors.initials: OR
authors.lastname: O'Neill
authors.forename: M L
authors.initials: ML
authors.lastname: Wynn
authors.forename: B M
authors.initials: BM
authors.lastname: Coull
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D001161:Arteriosclerosis / Q000000981:diagnostic imaging / Q000628:therapy; D002533:Cerebral Angiography; D002561:Cerebrovascular Disorders / Q000209:etiology; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging / Q000628:therapy*; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D015609:Organotechnetium Compounds; D010091:Oximes; D012008:Recurrence; D012449:Safety; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon; D017539:Tunica Intima / Q000473:pathology
chemical_list: D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime