Background and purpose: Our objective was to find the specific angiographic characteristics of atherosclerotic lesions that indicate suitability for intracranial percutaneous transluminal cerebral balloon angioplasty (PTCBA).
Methods: Forty-two clinically symptomatic patients with 42 hemodynamically significant intracranial lesions (>70% stenosis) were treated by PTCBA between January 1992 and May 1996. Before treatment, the patients were assigned to three groups according to the angiographic characteristics of the lesions, as follows: type A, short (5 mm or less in length) concentric or moderately eccentric lesions less than totally occlusive; type B, tubular (5 to 10 mm in length), extremely eccentric or totally occluded lesions, less than 3 months old; and type C, diffuse (more than 10 mm in length), extremely angulated (>90 degrees) lesions with excessive tortuosity of the proximal segment, or totally occluded lesions, and 3 months old or older. The patients were followed up for a period of 1 month to 6 years to compare the results of PTCBA treatment among the three groups. Primary end points were death, stroke, or bypass surgery.
Results: The clinical success rates for the type A, B, and C groups were 92%, 86%, and 33%, respectively. Cumulative risks of fatal or nonfatal ischemic stroke or ipsilateral bypass surgery in type A, B, and C groups were 8%, 26%, and 87%, respectively. The cumulative risk of 8% among patients in the type A group appeared to be smaller than in studies reported in the literature.
Conclusion: PTCBA for intracranial simple (type A) lesions yields a favorable clinical outcome for symptomatic patients.