BACKGROUND AND PURPOSE: The clinical outcome is often poor in acute stroke patients with a serious neurological status due to occlusive lesions of the intracranial vertebral and/or basilar artery (IVBA). The purpose of this study was to investigate retrospectively the clinical features and outcome of acute stroke patients who underwent transluminal angioplasty and/or stenting (TAS) for occlusive lesions of the IVBA and to clarify the prerequisites for improvement of outcome. MATERIALS AND METHODS: Of 1690 consecutive acute ischemic stroke patients admitted to our institution, TAS for occlusive lesions of the IVBA was performed within 7 days after stroke onset in 28 patients. We classified these patients into 2 groups, those with total occlusion (occlusion group) and those with a high-grade stenosis (stenosis group), and compared the preprocedural neurologic status (severe: National Institutes of Health Stroke Scale >20), the rate of technical success, major procedure-related complications, subacute occlusion of the treated vessel, and favorable clinical outcome (0-2 points on a 3-month modified Rankin Scale) between the 2 groups. RESULTS: In the occlusion group (n = 16) and stenosis group (n = 12), a severe preprocedural neurologic status was seen in 13 and 1 patients, respectively (81% versus 8%; P = .0001); technical success was achieved in 13 and 11 patients, respectively (81% versus 92%; P value not significant [NS]); complications occurred in 6 and 0 patients, respectively (38% versus 0%; P < .05); subacute occlusion was seen in 4 and 1 patients, respectively (25% versus 8%; P = NS); and a favorable clinical outcome was obtained in 3 and 9 patients, respectively (19% versus 75%; P < .01). CONCLUSION: The clinical outcome of patients who underwent TAS for total occlusion of the IVBA was poor. Improvement of outcome requires reduction of procedure-related complications and subacute occlusion.
BACKGROUND AND PURPOSE: The clinical outcome is often poor in acute strokepatients with a serious neurological status due to occlusive lesions of the intracranial vertebral and/or basilar artery (IVBA). The purpose of this study was to investigate retrospectively the clinical features and outcome of acute strokepatients who underwent transluminal angioplasty and/or stenting (TAS) for occlusive lesions of the IVBA and to clarify the prerequisites for improvement of outcome. MATERIALS AND METHODS: Of 1690 consecutive acute ischemic strokepatients admitted to our institution, TAS for occlusive lesions of the IVBA was performed within 7 days after stroke onset in 28 patients. We classified these patients into 2 groups, those with total occlusion (occlusion group) and those with a high-grade stenosis (stenosis group), and compared the preprocedural neurologic status (severe: National Institutes of Health Stroke Scale >20), the rate of technical success, major procedure-related complications, subacute occlusion of the treated vessel, and favorable clinical outcome (0-2 points on a 3-month modified Rankin Scale) between the 2 groups. RESULTS: In the occlusion group (n = 16) and stenosis group (n = 12), a severe preprocedural neurologic status was seen in 13 and 1 patients, respectively (81% versus 8%; P = .0001); technical success was achieved in 13 and 11 patients, respectively (81% versus 92%; P value not significant [NS]); complications occurred in 6 and 0 patients, respectively (38% versus 0%; P < .05); subacute occlusion was seen in 4 and 1 patients, respectively (25% versus 8%; P = NS); and a favorable clinical outcome was obtained in 3 and 9 patients, respectively (19% versus 75%; P < .01). CONCLUSION: The clinical outcome of patients who underwent TAS for total occlusion of the IVBA was poor. Improvement of outcome requires reduction of procedure-related complications and subacute occlusion.
Authors: R T Higashida; G B Hieshima; F Y Tsai; V V Halbach; D Norman; T H Newton Journal: AJNR Am J Neuroradiol Date: 1987 Sep-Oct Impact factor: 3.825
Authors: Eli I Lev; Ran Kornowski; Igal Teplisky; David Hasdai; Eldad Rechavia; Nurit Shor; Alexander Battler; Abid R Assali Journal: Int J Cardiovasc Intervent Date: 2005
Authors: F Alfonso; P Rodriguez; P Phillips; J Goicolea; R Hernández; M J Pérez-Vizcayno; A Fernández-Ortiz; J Segovia; C Bañuelos; P Aragoncillo; C Macaya Journal: J Am Coll Cardiol Date: 1997-03-15 Impact factor: 24.094
Authors: Elad I Levy; Ricardó A Hanel; Alan S Boulos; Bernard R Bendok; Stanley H Kim; Kevin J Gibbons; Adnan I Qureshi; Lee R Guterman; L Nelson Hopkins Journal: J Neurosurg Date: 2003-10 Impact factor: 5.115
Authors: Adnan I Qureshi; Wendy C Ziai; Abutaher M Yahia; Yousef Mohammad; Souvik Sen; Pinky Agarwal; Osama O Zaidat; Jose I Suarez; Robert J Wityk Journal: Neurosurgery Date: 2003-05 Impact factor: 4.654