title: Endovascular therapy for acute thrombotic occlusion of the intracranial artery.
abstract: The goal of this study was to evaluate the efficacy of endovascular therapy for acute thrombotic occlusion. Six patients with acute thrombotic occlusion in the middle cerebral or basilar arteries underwent treatment with intra-arterial thrombolysis, followed by assessment of residual stenosis. If residual stenosis was greater than 70%, percutaneous transluminal angioplasty (PTA) was performed in the same session; otherwise, patients were anticoagulated, and PTA was performed several days later. Successful recanalization was achieved in five of six patients. One patient died of massive infarction, because of the failure of recanalization of the M1 segment. At discharge, modified Rankin scale distribution of the patients was: grade 0, one patient; grade 1, one patient; grade 2, two patients; grade 3, one patient; grade 6, one patient. Retreatment was required via PTA or stenting in two patients in which type C stenosis was present. In conclusion, endovascular therapy for acute thrombotic occlusion of an intracranial artery appears to be effective compared to conservative therapy. However, further refinement of the technique is required to prevent various complications, including vessel perforation, dissection, perforating artery occlusion and restenosis.
authors.affiliation: Department of Neurological Surgery, Wakayama Medical University, Wakayama, Japan. tsumotot@wakayama-med.ac.jp
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Tsumoto
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Terada
authors.forename: Mitsuharu
authors.initials: M
authors.lastname: Tsuura
authors.forename: Yukiaki
authors.initials: Y
authors.lastname: Ryujin
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Matsumoto
authors.forename: Osamu
authors.initials: O
authors.lastname: Masuo
authors.forename: Hiroo
authors.initials: H
authors.lastname: Yamaga
authors.forename: Toru
authors.initials: T
authors.lastname: Itakura
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D020767:Intracranial Thrombosis / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D019233:Retreatment; D015607:Stents; D015912:Thrombolytic Therapy
chemical_list: D005343:Fibrinolytic Agents