Recurrent abrupt occlusion after transluminal angioplasty for basilar artery stenosis: case report

Neurosurgery. 1999 Jan;44(1):210-5. doi: 10.1097/00006123-199901000-00127.


Objective and importance: Angioplasty for basilar artery stenosis is often complicated by recurrent abrupt vessel closure. The clinical results can be catastrophic. In this case report, we assess the effects of intra-arterial papaverine (American Regent Laboratories Inc., Shirley, NJ) on rebound occlusion.

Clinical presentation: The patient presented with crescendo transient ischemic attacks from atherosclerotic narrowing of the midbasilar artery despite maximal medical treatment.

Intervention: Angioplasty of the midbasilar artery was performed with serial balloon inflations. The patient was treated successfully with intra-arterial papaverine and achieved a nearly full recovery, with only mild dysarthria, by the time of the 7-month follow-up examination.

Conclusion: Using intra-arterial papaverine, we were able to reverse the effects of this potentially life-threatening complication of basilar artery angioplasty.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Angioplasty, Balloon*
  • Basilar Artery
  • Cerebral Angiography
  • Cerebral Infarction / diagnosis
  • Cerebral Infarction / therapy*
  • Humans
  • Infusions, Intra-Arterial
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neurologic Examination
  • Papaverine / administration & dosage
  • Recurrence
  • Vasodilator Agents / administration & dosage
  • Vertebrobasilar Insufficiency / diagnosis
  • Vertebrobasilar Insufficiency / therapy*


  • Vasodilator Agents
  • Papaverine