Preliminary Clinical Observations Of Angioplasty For Symptomatic Intracranial Artery Stenosis

Objective: To investigate the effectiveness and safety of angioplasty for symptomaticintracranial artery stenosis.Methods: Eleven patients with symptomatic intracranial artery stenosis treated withendovascular angioplasty admitted in our hospital from November of 2004 to March of 2007were analysed and followed for 2 to 27 months. Therapeutic effects were evaluated byanalysing clinical manifestations, results of Digital Subtraction Angiography (DSA) andTranscranial Doppler Ultrasound (TCD) before and after the operation.Results:1) There are 7 males and 4 females between 45 to 75 years of age. Seven got cerebralinfarction and 4 got (Transient Ischeamic Attach) TIA. Three acute patients underwentsurgical operation of cerebral infarction. There are 3 to 32 days of duration between theonset of the disease and time of the operation in the rest patients2) Endovascular stent-assisted angioplasty was performed successfully in 9 patients, but failedin 2 patients due to the extreme circuitousness of the petrous segment of internal carotidartery. These 2 patients were later treated with balloon dilation.3) Angiographic results demonstrated that the mean degree of stenosis was significantlyreduced from 85.5% (range 50%～98%) before treatment to 2.8% (range 0%～20%)immediately after the procedure. Stenosis of the two patients treated with balloon dilation wasreduced.4) Cerebral parenchyma hematoma occurred in 1 patient within 24 hours following theoperation and died 3 days later. Intra-stent thrombosis occurred in 1 patient on the sixthday after angioplasty and stenting, which led to cerebral infarction of the distal cortex withsevere neurological dysfunction.5) During 2 to 27 months' follow-ups in the 10 patients, recurrent transient ischaemic attack(TIA) occurred in one patient within 2 months. No recurrent TIA and stroke occurred inthe other patients. Seven patients were under redetection from 2 to 27 months with nostenosis by serial TCD. Four patients were redetected by DSA after≧ 12 months'follow-ups. Arterial occlusion (asymptomatic) was found in the previously endovascular stent-assisted blood vessels with many lateral branches in one patient. No stenosis wasdetected in the other 3 patients.Conclusions: Endovascular angioplasty is an effective and relatively safe therapeutic techniquefor symptomatic intracranial artery stenosis. However, its long-term effects need to bedetermined by further investigation.