Stent-angioplasty of intracranial vertebral and basilar artery stenoses in symptomatic patients.
BACKGROUND
To present our two-center treatment results with stent angioplasty of intracranial vertebrobasilar stenoses in symptomatic patients.


METHODS
Between 2001 and 2003, 21 patients with 22 stenoses, refractory to medical therapy, who underwent elective stenting of intracranial vertebrobasilar stenoses were retrospectively analyzed. All patients had ischemic events clinically referable to the stenoses. Only high-grade stenoses of at least 80% were treated. Clinical evaluation was done based on the modified ranking scale (MRS).


RESULTS
In all cases, the stent deployment turned out to be technically successful and control angiography demonstrated the elimination of the high-grade stenoses. A minor residual stenoses was still detectable in six cases. According to the MRS, clinical outcome improved in the case of four patients, seemed unchanged in 14 and worsened in three. The clinical morbidity rate amounted to 14%. Clinical follow-up was available for 13 patients after 9 months with no recurrent symptoms and angiographic follow-up was available after 10 months. Re-stenoses occurred in two cases without clinical symptoms. Retreatment was not done.


CONCLUSIONS
According to our data, stent angioplasty for symptomatic intracranial vertebrobasilar stenoses can be a treatment alternative in case of recurrent symptoms despite medical therapy; particularly, for stenoses of type Mori A or B.
Weber
Werner
W
Department of Radiology and Neuroradiology, Alfried Krupp Hospital Essen, Alfried Krupp Str. 21, D-45117 Essen, Germany.
Mayer
Thomas E
TE
Henkes
Hans
H
Kis
Bernhard
B
Hamann
Gerhard F
GF
Schulte-Altedorneburg
Gernot
G
Brueckmann
Hartmut
H
Kuehne
Dietmar
D
D000368:Aged; D017130:Angioplasty / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014711:Vertebral Artery; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging / Q000628:therapy*