title: Effectiveness of Intracranial Percutaneous Transluminal Angioplasty or Stenting for Atherosclerotic Vertebrobasilar Artery Occlusion in the Acute Phase of Ischemic Stroke.
abstract: OBJECTIVE
  Although short-term clinical outcomes after basilar artery stent placement have been reported previously, effectiveness of intracranial stenting for vertebrobasilar artery occlusion in the acute phase of ischemic stroke is unclear.
  
  
  METHODS
  We clinically investigated 8 patients with intracranial percutaneous transluminal angioplasty (PTA) or stenting as our protocol for symptomatic atherosclerotic vertebrobasilar artery occlusion (age range, 54-80 years; mean age, 69 ± 11 years; 6 men and 2 women) who were admitted to our hospital between August 2013 and December 2015.
  
  
  RESULTS
  Two patients underwent PTA of the vertebrobasilar artery 2-5 months before stent placement. The other 6 patients underwent intracranial stenting just after PTA. Within the first 30 days after vertebrobasilar artery stent placement, 2 ischemic stroke complications affected patients. Ischemic complications were significantly associated with prestent lesion lumen greater than 0.5 mm. The modified Rankin Scale score and clinical outcome were significantly associated with complications. Clinical outcomes correlate with ischemic complications and vertebrobasilar anatomy.
  
  
  CONCLUSIONS
  Stent angioplasty may be a reasonably good treatment option for patients with technically favorable lesions, especially in vertebrobasilar atherosclerotic occlusion with medically or PTA only refractory symptoms. Despite a significant complication rate, most of our patients experienced good to excellent clinical outcomes and were free of vertebrobasilar ischemia at late midterm follow-up.
authors.affiliation: Department of Neurosurgery, Nara Medical University, Kashihara City, Japan; Department of Neurosurgery, Osaka Police Hospital, Osaka City, Japan. Electronic address: wajima@naramed-u.ac.jp.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Wajima
authors.affiliation: Department of Neurosurgery, Osaka Police Hospital, Osaka City, Japan.
authors.forename: Shuta
authors.initials: S
authors.lastname: Aketa
authors.affiliation: Department of Neurosurgery, Nara Medical University, Kashihara City, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Nakagawa
authors.affiliation: Department of Neurosurgery, Osaka Police Hospital, Osaka City, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Masui
authors.affiliation: Department of Neurosurgery, Osaka Police Hospital, Osaka City, Japan.
authors.forename: Taiji
authors.initials: T
authors.lastname: Yonezawa
authors.affiliation: Department of Neurology, Osaka Police Hospital, Osaka City, Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Enami
authors.affiliation: Department of Neurology, Osaka Police Hospital, Osaka City, Japan.
authors.forename: Fukuko
authors.initials: F
authors.lastname: Nishida
authors.affiliation: Department of Neurosurgery, Nara Medical University, Kashihara City, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakase
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000379:methods* / Q000639:trends; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Intracranial stenting; Ischemic complications; Percutaneous transluminal angioplasty (PTA); Symptomatic atherosclerotic vertebrobasilar artery occlusion