Endovascular surgery for acute vertebrobasilar stenosis and occlusion

• Published in: Japanese Journal of Stroke Vol. 27; no. 3; pp. 389 - 395
• Main Authors: Masamura, Seiya, Matsuo, Takashi, Nakamura, Kazuhito, Sakaguchi, Masakazu, Kawakami, Taichiro, Ichinose, Tsutomu, Terakawa, Yuzo, Murata, Keiji
• Format: Journal Article
• Language: Japanese
• Published: The Japan Stroke Society 2005
• Subjects: cerebral infarction; PTA; stent; vertebrobasilar system
• ISSN: 0912-0726; 1883-1923
• DOI: 10.3995/jstroke.27.389

Background and Purpose: We performed endovascular recanalization in 6 patients (7 times) with acute vertebrobasilar stenosis and occlusion out of 60 patients who underwent endovascular surgery during a 2-year period from April 2002 to March 2004. Their ages ranged from 56 to 77 years (mean: 68 years). All 6 patients were male. The affected lesions were the vertebral artery (VA) in 2 cases (3 times), the basilar artery (BA) in 3 cases, and the posterior cerebral artery in 1 case. Methods: The extent of improvement in the National Institutes of Health Stroke Scale (NIHSS), and the rates of improvement in the Glasgow Outcome Scale (GOS) and stenosis were examined. Results: The outcome was 3 case of Good Recovery (GR), one case of Moderately Disabled (MD), 1 case of Severely Disabled (SD), and 1 case of Dead (D). The stenosis improvement rates ranged from 0 to 80% (mean: 63%). The mean NIHSS improved from 24 before endovascular surgery to 16 after surgery. The 3 severe patients who had an NIHSS of at least 23 before endovascutar surgery revealed a poor prognosis (1 case of D and 2 cases of SD) even after endovascular recanalization at the acute stage. Conclusion: The present findings suggest that such treatment is not indicated in patients with a high NIHSS. However, endovascular recanalization centered on percutaneous transluminal angioplasty (PTA) is an effective treatment in moderate NIHSS cases. Endovascular recanalization centered on PTA for acute ischemic stroke in the vertebrobasilar system could well provide the effect of improving prognosis.