title: Intracranial percutaneous transluminal angioplasty for arteriosclerotic stenosis.
abstract: BACKGROUND
  Patients with intracranial arteriosclerotic disease have significant morbidity and mortality rates, and some are unresponsive to medical treatment and have unacceptable surgical risks. Percutaneous transluminal angioplasty of the intracranial vessels is a possible alternative to surgery.
  
  
  OBJECTIVE
  To present our experience with percutaneous transluminal angioplasty and to summarize our data.
  
  
  METHODS
  Sixteen patients underwent intracranial percutaneous transluminal angioplasty for high-grade arteriosclerotic stenosis based on strict inclusion and exclusion criteria. All patients had symptoms referable to the stenosis except one. Angioplasty was performed in 6 intracranial vertebral arteries, 3 basilar arteries, 5 middle cerebral arteries, and 3 distal internal carotid arteries. One patient had concomitant stent placement.
  
  
  RESULTS
  There was 1 treatment failure secondary to tortuous vascular anatomy. Vessel caliber was increased to more than 80% of normal in 6 patients and to 50% to 70% of normal in 6 patients, with a reduction of symptoms. Three intimal dissections occurred during angioplasty; one of these, in a precavernous segment of the internal carotid artery, was stented. One patient restenosed within 1 month of treatment. The remaining treated arteries remained patent during follow-up of 3 months to 2 years. Stroke as a complication occurred in 2 patients, 1 mild and 1 severe. There was no mortality.
  
  
  CONCLUSIONS
  Occlusive arteriosclerotic disease involving the intracranial cerebral vessels can be managed medically with antiplatelet and anticoagulant drug therapy or surgically. However, in patients who are unresponsive to medical therapy or who have unacceptable surgical risks, percutaneous transluminal angioplasty is an attractive alternative that can be performed in selected patients with relatively low risk and good clinical outcome.
authors.affiliation: Department of Neurosurgery, University of Illinois at Chicago, MC 799, 912 S Wood St, Chicago, IL 60612, USA.
authors.forename: A
authors.initials: A
authors.lastname: Alazzaz
authors.forename: J
authors.initials: J
authors.lastname: Thornton
authors.forename: V A
authors.initials: VA
authors.lastname: Aletich
authors.forename: G M
authors.initials: GM
authors.lastname: Debrun
authors.forename: J I
authors.initials: JI
authors.lastname: Ausman
authors.forename: F
authors.initials: F
authors.lastname: Charbel
mesh_terms: D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon / Q000379:methods*; D001488:Basilar Artery / Q000601:surgery; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000601:surgery; D018579:Patient Selection; D012189:Retrospective Studies; D016896:Treatment Outcome