Document Detail


Transluminal angioplasty and stenting for intracranial vertebrobasilar occlusive lesions in acute stroke patients.
MedLine Citation:
PMID:  18202237     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
K Imai; T Mori; H Izumoto; T Kunieda; N Takabatake; S Yamamoto; M Watanabe
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Publication Detail:
Type:  Journal Article     Date:  2008-01-17
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  29     ISSN:  1936-959X     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-09     Completed Date:  2008-06-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  773-80     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Acute Stroke Center of Kyoto First Red Cross Hospital, Kyoto, Japan. keisuke@qb4.so-net.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angioplasty, Balloon* / adverse effects
Female
Humans
Male
Middle Aged
Stents*
Stroke / etiology*
Treatment Outcome
Vertebrobasilar Insufficiency / complications,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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