Angioplasty and stenting of basilar artery stenosis: technical case report

Neurosurgery. 1999 Aug;45(2):404-7; discussion 407-8. doi: 10.1097/00006123-199908000-00047.


Objective and importance: Symptomatic basilar artery stenosis has a poor prognosis. Treatment options are limited. Surgical bypasses are technically demanding and of no proven benefit. Percutaneous angioplasty is associated with a significant complication rate, because of intraplaque dissection, restenosis secondary to vessel recoil, and embolic phenomena. A new generation of intravascular stents that are flexible enough to navigate the tortuosities of the vertebral artery may provide a new therapeutic approach. We report a case of basilar artery stenosis that was treated using stent-assisted angioplasty.

Clinical presentation: A 56-year-old woman experienced a vertebrobasilar ischemic stroke, from which she recovered. Magnetic resonance angiography revealed severe proximal basilar artery stenosis. Brain Neurolite-single-photon emission computed tomographic scans revealed significantly decreased perfusion of the brainstem. Endovascular intra-arterial pressure measurements revealed a 35-mm Hg gradient across the lesion.

Intervention: The patient underwent uncomplicated angioplasty and stenting of the proximal basilar artery, with excellent angiographic results.

Conclusion: The availability of new flexible intravascular stents, allowing access to tortuous proximal intracranial vessels, provides a new therapeutic approach for patients with basilar artery stenosis. Long-term follow-up monitoring is required to assess the durability of this approach.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiography, Digital Subtraction
  • Angioplasty*
  • Arterial Occlusive Diseases / diagnosis
  • Arterial Occlusive Diseases / therapy*
  • Basilar Artery* / diagnostic imaging
  • Female
  • Fluoroscopy
  • Humans
  • Middle Aged
  • Stents*
  • Tomography, Emission-Computed, Single-Photon