BACKGROUND AND PURPOSE: In some patients with stenosis of an intracranial artery, navigating the balloon or stent-delivery system is difficult of tortuous anatomy of the aortic arch, carotid arteries, or vertebral arteries Our purpose was to describe techniques of intracranial stent placement that help in navigating the stent-delivery system in tortuous vessels. METHODS: Between May 1998 and June 2004, 73 symptomatic stenotic (>50%) intracranial arteries were successfully treated with stent-assisted angioplasty. In 11 cases, standard techniques of navigating the stent-delivery system into the intended lesion failed because of vascular tortuosity. In these difficult cases, several techniques were used to overcome the tortuosity. Five lesions were located in the middle cerebral arteries, four were in the supraclinoid internal carotid arteries, and two were in the distal vertebral arteries. RESULTS: In all difficult cases, stents were successfully placed in the intracranial artery by using several techniques: 1) waiting method in which we waited for 20-30 minutes after advancement of the microwire across the lesion, 2) the double-wire technique, and 3) the coaxial double-guiding catheter technique. The waiting method made smooth stent navigation possible in five cases, the double-wire technique was successful in four cases, and the coaxial double-guiding catheter technique was effective in two cases. No technique-related complications occurred. CONCLUSION: In difficult cases in which standard techniques of navigating the stent-delivery system into the intended lesion fail because of vascular tortuosity, our techniques were useful methods for intracranial stent navigation.
BACKGROUND AND PURPOSE: In some patients with stenosis of an intracranial artery, navigating the balloon or stent-delivery system is difficult of tortuous anatomy of the aortic arch, carotid arteries, or vertebral arteries Our purpose was to describe techniques of intracranial stent placement that help in navigating the stent-delivery system in tortuous vessels. METHODS: Between May 1998 and June 2004, 73 symptomatic stenotic (>50%) intracranial arteries were successfully treated with stent-assisted angioplasty. In 11 cases, standard techniques of navigating the stent-delivery system into the intended lesion failed because of vascular tortuosity. In these difficult cases, several techniques were used to overcome the tortuosity. Five lesions were located in the middle cerebral arteries, four were in the supraclinoid internal carotid arteries, and two were in the distal vertebral arteries. RESULTS: In all difficult cases, stents were successfully placed in the intracranial artery by using several techniques: 1) waiting method in which we waited for 20-30 minutes after advancement of the microwire across the lesion, 2) the double-wire technique, and 3) the coaxial double-guiding catheter technique. The waiting method made smooth stent navigation possible in five cases, the double-wire technique was successful in four cases, and the coaxial double-guiding catheter technique was effective in two cases. No technique-related complications occurred. CONCLUSION: In difficult cases in which standard techniques of navigating the stent-delivery system into the intended lesion fail because of vascular tortuosity, our techniques were useful methods for intracranial stent navigation.
Authors: Yong Sam Shin; Sun Young Kim; Oh Young Bang; Pyoung Jeon; Soo Han Yoon; Ki Hong Cho; Kyung Gi Cho Journal: J Clin Neurosci Date: 2003-01 Impact factor: 1.961
Authors: Dae Chul Suh; Soo-Hyun Lee; Kyung Rae Kim; Sung Tae Park; Soo Mee Lim; Sang Joon Kim; Choong Gon Choi; Ho Kyu Lee Journal: AJNR Am J Neuroradiol Date: 2003-02 Impact factor: 3.825
Authors: Donald A Eckard; Kyle A Krehbiel; Philip L Johnson; Timothy G Raveill; Valerie R Eckard Journal: AJNR Am J Neuroradiol Date: 2003-02 Impact factor: 3.825
Authors: M I Chimowitz; J Kokkinos; J Strong; M B Brown; S R Levine; S Silliman; M S Pessin; E Weichel; C A Sila; A J Furlan Journal: Neurology Date: 1995-08 Impact factor: 9.910
Authors: R Gupta; H C Schumacher; S Mangla; P M Meyers; H Duong; A G Khandji; R S Marshall; J P Mohr; J Pile-Spellman Journal: Neurology Date: 2003-12-23 Impact factor: 9.910
Authors: William J Ares; Benjamin M Zussman; Cynthia L Kenmuir; Gregory M Weiner; Habibullah Ziayee; Devin Burke; Ashutosh P Jadhav; Tudor G Jovin; Brian T Jankowitz; Bradley A Gross Journal: Interv Neurol Date: 2018-05-31