Percutaneous angioplasty of a chronic total occlusion of the intracranial internal carotid artery. Case report.
BACKGROUND
A CTO of the intracranial ICA is usually managed medically and rarely by EC-IC bypass in selected patients. Percutaneous transluminal angioplasty has not been used.


METHODS
A 73-year-old man presented with frequent temporary blindness of the left eye and dizziness due to thrombotic occlusion of the left intracranial ICA, causing hemodynamic compromise. This patient was successfully treated by percutaneous angioplasty (balloon angioplasty and stent placement) under proximal balloon protection at 7 weeks from the ictus. Ischemic symptoms had not recurred during the 6-month follow-up period.


CONCLUSIONS
Percutaneous angioplasty for a CTO of the intracranial ICA is technically feasible and can be an alternative to EC-IC bypass in a selected group of patients with symptomatic hemodynamic compromise, which is refractory to the best medical treatment.
Komiyama
Masaki
M
Department of Neurosurgery, Osaka City General Hospital, Osaka 534-0021, Japan. komiyama@japan-mail.com
Yoshimura
Masaki
M
Honnda
Yuji
Y
Matsusaka
Yasuhiro
Y
Yasui
Toshihiro
T
D000368:Aged; D000800:Angioplasty, Balloon / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D001766:Blindness / Q000209:etiology / Q000503:physiopathology; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002533:Cerebral Angiography; D002548:Cerebral Revascularization / Q000592:standards; D002560:Cerebrovascular Circulation / Q000502:physiology; D002908:Chronic Disease; D004244:Dizziness / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D018570:Risk Assessment; D015607:Stents / Q000592:standards / Q000706:statistics & numerical data / Q000639:trends*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome