Transluminal angioplasty and stenting for the intracranial and extracranial cerebral       arterial stenosis : Preliminary experiences

J Korean Neurol Assoc > Volume 15(3); 1997 > Article

Journal of the Korean Neurological Association 1997;15(3): 517-525.

두개내 뇌동맥과 두개외 뇌동맥 협착의 경관혈관 성형술 및 스텐트 삽입술 : 예비연구

최일수, 서대철, 이재홍, 김종성, 이명종

울산대학교 의대 신경과

Transluminal angioplasty and stenting for the intracranial and extracranial cerebral arterial stenosis : Preliminary experiences

Il Soo Choi, Dae Chul Suh, Jae Hong Lee, Jong Sung Kim, Myung Chong Lee

Department of Neurology and Radiology, University of Ulsan, Asan Medical Center

Abstract

Purpose : To report the preliminary results of percutaneous transluminal balloon angioplasty (PTA) and stenting for the intracranial or extracranial care bral arterial stenosis. Methods : In 11 patient% a total of 12 hemodynamically significant arterial stenatic lesions were treated by tramluminal angioplasty with or without the we of stent ; 8 proiml internal carotid arteries (ICA), 2 middle cerebral arteries (MCA), I distal vertebral artery (VA) and I proximal VA. We performed stent placement for 7 ICA lesions, while we did PTA alone for 2 MCA stenoses. PTA for 1 ICA and 2 VA lesions was performed while we attempted intraarterial urokinam (IAUK) therapy. Results : Mean residual stenosis measured immediately after the procedure was 7% (range 0-27%) in 7 ICA lesions (treated by slanting), 13% and 29% in 2 MCA lesions (PTA), and 38% (range 32 41%) in 1 ICA and 2 VA lesions (PTA after IALJK). During and immediately after the procedure, 2 patients with ICA stenwis developed a transient ischemic attack (TIA) and one patient with ICA stenosis showed the infarct progression. Two patients, who were treated by PTA during IAUK therapy, expired. During the follow-up period (range, 4-18 months; mean, 8.6 months), all patients but one with the MCA lesion were free from further ischemic events. Conclusions : The efficacy and safety of PTA and stenting were not sufficiently verified with the small number of cases in our series. However, our observations suggest that they may be used as an alternative treatment modality to endarterectomy or a new promising therapy for the extracranial or intracranial arterial stenosis.