Long-term outcome after elective stent assisted intracranial angioplasty for atherosclerotic occlusive disease

Abstract

The purpose of this study was to evaluate the long-term angiographic and clinical efficacy of stent assisted intracranial angioplasty (SAIA) for the treatment of symptomatic atherosclerotic occlusive disease. Since November 2000, 15 elective cases (13 men and 2 women; mean age, 70.4 years) have been followed up for at least 12 months after SAIA (mean follow-up, 27.2 months; range, 12-64 months). In all cases, medical therapy had failed and all lesions showed >70% luminal, long and tortuous stenosis or total occlusion (Mori type B 11 and type C 4) which was unsuitable for treatment by balloon angioplasty alone. The lesions were located at the intracranial ICA in 6, M1 in 1, intracranial VA in 5 and BA in 3 patients. The average stenosis rate was reduced from 81.7% to 17.0%. No periprocedural complications occurred in any of the cases. The periprocedural neurological morbidity and mortality was 0%. Angiographic follow-up was available in all cases, and significant restenosis was observed in 2 cases (13.3%) during the follow-up period. One case of restenosis was detected at 3 months after SAIA and was treated by percutaneous transluminal balloon angioplasty. The other was detected after 12 months. There was no recurrent clinical ischemia following successful SAIA, including the 2 cases which exhibited restenosis. With safe procedures and strict indications, SAIA is considered effective for long-term stroke prevention.