頭蓋内椎骨脳底動脈系動脈硬化性狭窄病変に対するangioplastyおよびstentingの臨床成績

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Recently, angioplasty/stenting has been reported as a treatment option for intracranial atherosclerotic stenosis. We describe clinical results of angioplasty/stenting for 21 patients with intracranial vertebrobasilar stenosis (21 lesions). The procedure was performed under local anesthesia via the percutaneous transfemoral route. In 13 cases, we performed angioplasty only, while we used stents in 8 of 21 cases. The mean stenosis in 13 cases of angioplasty decreased from 76.2% to 26.4%, while 82.5% of the stenotic rate remarkably reduced to 11.3% in 8 cases of stenting. The 30-day morbidity and 30-day mortality rate were 4.8% and 0%, respectively. There was only 1 hemorrhagic complication (cerebellar hemorrhage) in case of stenting, and no ischemic events during or after the procedures. Restenosis (more than 50%) occurred in 3 of 21 cases (14.3%) during the mean follow-up period of 12 months. Our procedure-related morbidity and mortality rates were possibly not higher than those reported by other authors. In this study, angioplasty/stenting for intracranial vertebrobasilar artery stenosis was an effective treatment, but strict indications may be required because the procedure-related 30-day morbidity rate was still high compared with that of extracranial atherosclerotic stenosis, in addition to unknown natural history of intracranial vertebrobasilar stenosis.
日本脳卒中の外科学会の論文
2006-03-31

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