Effectiveness of intracranial percutaneous trans-luminal angioplasty (PTA) or stenting for atherosclerotic vertebro-basilar artery occlusion in acute phase of ischemic stroke

Abstract Objective Although short-term clinical outcomes after basilar artery stent placement have been reported previously, effectiveness of intracranial stenting for vertebro-basilar artery occlusion in acute phase of ischemic stroke is unclear. Methods We clinically investigated 8 patients with intracranial percutaneous trans-luminal angioplasty (PTA) or stenting as our protocol for symptomatic atherosclerotic vertebra-basilar artery occlusion (age range 54–80, mean 69±11 years; 6 male and 2 female) who were admitted to our hospital between August 2013 and December 2015. Results Two patients underwent PTA of the vertebra-basilar artery 2–5 months before stent placement. Other 6 patients underwent intracranial stenting just after PTA. Within the first 30 days after vertebro-basilar artery stent placement, 2 ischemic stroke complications affected patients. Ischemic complications were significantly associated with pre-stent lesion lumen over 0.5 mm. The modified Rankin Score and clinical outcome were significantly associated with complications. Clinical outcomes correlate with ischemic complications and vertebro-basilar anatomy. Conclusions Stent angioplasty may be a reasonably good treatment option for patients with technically favorable lesions, especially in vertebra-basilar atherosclerotic occlusion with medically or PTA only refractory symptoms. Despite a significant complication rate, most of our patients experienced good to excellent clinical outcomes and were free of vertebra-basilar ischemia at late midterm follow-up.