title: Perioperative complications of recanalization and stenting for symptomatic nonacute vertebrobasilar artery occlusion.
abstract: BACKGROUND
  Endovascular recanalization and stenting has been used to treat patients with symptomatic nonacute intracranial vertebrobasilar artery occlusion (VBAO) refractory to aggressive medical treatment. This study was performed to analyze the perioperative complications of the procedures.
  
  
  METHODS
  Between February 2010 and March 2012, 27 consecutive patients (24 men, 3 women; age: 57 ± 10 years) with symptomatic, nonacute intracranial VBAO including 12 basilar artery occlusions and 15 vertebral artery occlusions were collected and retrospectively analyzed.
  
  
  RESULTS
  The median time between symptom onset and recanalization was 1.5 months (interquartile range [IQR]: 0.7-3.4) and between imaging-documented occlusion and recanalization was 9.5 days (IQR: 6-18 days). Recanalization was achieved in 96% of patients (26/27). Five (5/27; 19%) perioperative complications occurred. Two patients had dissections: 1 dissection resulted in termination of the procedure without successful recanalization, and the other was handled by the placement of 2 stents. There was 1 intraprocedural acute thrombosis that was successfully treated with balloon angioplasty. One patient experienced thrombus disruption and translocation during the procedure: thrombus was dislodged after disruption by the guidewire. There was 1 acute reocclusion after procedure: while recanalization was achieved again, there was no improvement in clinical outcome.
  
  
  CONCLUSIONS
  This study revealed that recanalization and stenting for nonacute VBAO may be technically feasible but that it is accompanied by a high risk of complication. The causative factors for perioperative complications need future study.
authors.affiliation: Cerebrovascular Center, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China; The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Yingkun
authors.initials: Y
authors.lastname: He
authors.affiliation: Cerebrovascular Center, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China.
authors.forename: Weixing
authors.initials: W
authors.lastname: Bai
authors.affiliation: Cerebrovascular Center, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China. Electronic address: dr.litianxiao@vip.163.com.
authors.forename: Tianxiao
authors.initials: T
authors.lastname: Li
authors.affiliation: Cerebrovascular Center, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China.
authors.forename: Jiangyu
authors.initials: J
authors.lastname: Xue
authors.affiliation: Cerebrovascular Center, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China.
authors.forename: Ziliang
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Cerebrovascular Center, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China.
authors.forename: Liangfu
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Cerebrovascular Center, Cleveland Clinic Foundation, Cleveland, OH.
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Hui
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation; D002533:Cerebral Angiography / Q000379:methods; D038524:Diffusion Magnetic Resonance Imaging; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D013927:Thrombosis / Q000209:etiology / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D020217:Vertebral Artery Dissection / Q000209:etiology / Q000628:therapy; D014715:Vertebrobasilar Insufficiency / Q000150:complications / Q000175:diagnosis / Q000601:surgery*