Endovascular therapy for acute thrombotic occlusion of the intracranial artery

The goal of this study was to evaluate the efficacy of endovascular therapy for acute thrombotic occlusion. Six patients with acute thrombotic occlusion in the middle cerebral or basilar arteries underwent treatment with intra-arterial thrombolysis, followed by assessment of residual stenosis. If re...

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Bibliographic Details
Published in:Neuroradiology 2004-06, Vol.46 (6), p.453-458
Main Authors: TSUMOTO, Tomoyuki, TERADA, Tomoaki, TSUURA, Mitsuharu, RYUJIN, Yukiaki, MATSUMOTO, Hiroyuki, MASUO, Osamu, YAMAGA, Hiroo, ITAKURA, Toru
Format: Article
Language:English
Subjects:
Aged
Angioplasty
Angioplasty, Balloon
Biological and medical sciences
Blood clots
Blood vessels
Female
Fibrinolytic Agents - therapeutic use
Humans
Intracranial Thrombosis - diagnostic imaging
Intracranial Thrombosis - therapy
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical research
Medical sciences
Medical treatment
Middle Aged
Nervous system
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Radiography
Retreatment
Stents
Thrombolytic Therapy
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Summary:The goal of this study was to evaluate the efficacy of endovascular therapy for acute thrombotic occlusion. Six patients with acute thrombotic occlusion in the middle cerebral or basilar arteries underwent treatment with intra-arterial thrombolysis, followed by assessment of residual stenosis. If residual stenosis was greater than 70%, percutaneous transluminal angioplasty (PTA) was performed in the same session; otherwise, patients were anticoagulated, and PTA was performed several days later. Successful recanalization was achieved in five of six patients. One patient died of massive infarction, because of the failure of recanalization of the M1 segment. At discharge, modified Rankin scale distribution of the patients was: grade 0, one patient; grade 1, one patient; grade 2, two patients; grade 3, one patient; grade 6, one patient. Retreatment was required via PTA or stenting in two patients in which type C stenosis was present. In conclusion, endovascular therapy for acute thrombotic occlusion of an intracranial artery appears to be effective compared to conservative therapy. However, further refinement of the technique is required to prevent various complications, including vessel perforation, dissection, perforating artery occlusion and restenosis.
ISSN:0028-3940
1432-1920
DOI:10.1007/s00234-004-1219-x