Abstract
Purpose : Indication and usefulness of endovascular treatment for intracranial large vessel stenosis are considered based on our clinical experience and literature review. Material and Methods : A total of 56 patients who received endovascular treatment were analyzed. Endovascular treatment was performed for the patients with symptomatic intradural stenosis and symptomatic/asymptomatic extradural stenosis when the stenotic degree was greater than 70%. Results : The technical success rate was high (98.2%) and a favorable outcome was obtained in 93 % of the patients. On the other hand, morbidity and mortality were observed in 4 of 56 patients (7.0%), and these were caused by perforator occlusion and thrombotic/hemorrhagic complication. Discussion and conclusions : It has been reported that ischemic events occur in more than 10% of patients despite medical treatment, and the effect of intracranial stenting has been expected. However, it was reported that the clinical results of the aggressive medical treatment group were superior to those of the stenting group in randomized controlled trial (SAMMPRIS trial). Therefore, aggressive medical treatment would be standard for symptomatic intracranial large vessel stenosis and endovascular treatment will be indicated for medically refractory patients. Also, it seemed important to avoid treating lesions close to perforators and to perform appropriate antithrombotic treatment to decrease complications.
