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Outcome of Endovascular Treatment in Symptomatic Intracranial Vascular Stenosis

Suh, Dae Chul    (Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Korea.   ); Kim, Sang Joon    (Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Korea.   ); Lee, Duk Hee    (Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Korea.   ); Kim, Won    (Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Korea.   ); Choi, Choong Gon    (Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Korea.   ); Lee, Jeong-Hyun    (Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Korea.   ); Kim, Hyun Jeong    (Department of Radiology, DaeJeon Catholic Hospital, Korea.   ); Kwon, Sun Uck    (Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Korea.   ); Kim, Jong Sung    (Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Korea.  );
  • 초록

    Objective The outcome evaluation for the revascularization of intracranial vascular stenoses has not been fully described due to the highly technical nature of the procedure. We report here on the early and late clinical outcomes of angioplasty and/or stenting of symptomatic severe intracranial vascular stenoses at a single institute. Materials and Methods Since 1995, we have treated 35 patients with symptomatic intracranial vascular stenosis (more than 70% stenosis, mean stenosis: 78.6% ± 6.2%). Angioplasty (n = 19) was performed for the horizontal segment of the middle cerebral artery (M1) (n = 16) and the basilar artery (BA) (n = 1), the intradural vertebral artery (VA) (n = 1), and the cavernous internal carotid artery (ICA) (n = 1). Stenting (n = 16) was performed for the cavernous or petrous ICAs (n = 9), the intradural VA (n = 3), BA (n = 2), and M1 (n = 2) artery. We assessed the angiographic success (defined as residual stenosis Results Angiographic success was achieved in 97% of our patients (34/35). There were four procedure-related complications (11%) including a death and a minor stroke. During the mean 22-month FU, the asymptomatic restenosis rate was 9% and the symptomatic restenosis rate was 6% in the target lesion and 9% in all the vascular territories. The Kaplan-Meier estimate was 70.6% (95% confidence interval = 46.5-94.7) after 33 months of FU. Conclusion In addition to a high angiographic success rate and an acceptable periprocedural complication rate, intracranial angioplasty and/or stenting revealed a relatively low symptomatic recurrence rate. Hemorrhage is a rare, but the physician must aware that potentially fatal periprocedural complications can occur.


  • 주제어

    Cerebral blood vessels, transluminal angioplasty .   Stents and prostheses.  

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