Percutaneous transluminal angioplasty for intracranial arteriosclerotic lesions

Abstract

We report 17 cases of intracranial arterial stenosis treated by percutaneous transluminal angioplasty (PTA), including 9 on the intracranial internal carotid (ICA), 4 on the middle cerebral (MCA), and 4 on vertebrobasilar artery (VBA) system. All patients had ischaemic brain symptoms and stenoses of more than 60% (calculated angiographically). We treated four patients by PTA for residual stenoses after thrombolysis for acute occlusion. We used PTA balloon catheters 2.0-3.5 mm in diameter for all procedures. As a rule, the balloon was inflated for 1 min at 6 atm. All arteries were successfully dilated (stenosis less than 50%) except for one treated by PTA for residual MCA stenosis after thrombolysis. The patient died of a massive infarct due to MCA reocclusion caused by arterial dissection. Stenosis recurred in 4 of 16 patients. Repeat PTA was successfully carried out in these cases. However, stenosis recurred in one of these patients 3 months after PTA, but the patient is being followed because he is asymptomatic. PTA of intracranial arteries is effective, but its indications should be based strictly on potential risks, such as acute occlusion derived from arterial dissection.

Point-of-Care Testing for Anticoagulation Monitoring in Neuroendovascular Procedures

“…Reported target ACT ranges have varied from 150 -200 seconds to 350 -400 seconds. [50][51][52][53] Data regarding the optimal ACT for neuroendovascular procedures are scant because testing methods and ACT goal ranges are not commonly reported. Most of the evidence available is based on experts' opinion and/or extrapolated from PCI literature.…”

Reporting Standards for Angioplasty and Stent-Assisted Angioplasty for Intracranial Atherosclerosis

“…The postangioplasty stenosis grade defining technical success varies from Յ20% residual stenosis, 70 Յ30% residual stenosis, 96 but most commonly Յ50% residual stenosis. 2,54,58,60,68,94,119 Most importantly, technical success should be heralded by freedom from ipsilateral ischemic or hemorrhagic strokes in the distribution of the treated target stenosis.…”

Angioplasty and Stenting of Symptomatic Vertebral Artery Stenosis Clinical and Angiographic Follow-up of 206 Cases from Northwest Iran

“…A nonrandomized case series suggested that VAS may be treated using an endovascular method such as PTA and/or stenting and is associated with low morbidity and mortality [14][15][16] . However, results of PTA performed to relieve stenosis in the posterior intracranial circulation have been conflicting [17][18][19] . Thus, we conducted a prospective study to evaluate the efficacy, safety, and long-term follow-up of 206 patients who received PTA with a stent implant to treat their symptomatic atherosclerotic VAS.…”