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ASNR: Stenting Provides Initial Treatment Gains For Intracranial Atherosclerotic Stenosis By Maria Bishop Special to DG News BOSTON, MA -- April 24, 2001 -- Stenting is effective in treating symptomatic intracranial arterial stenosis from atherosclerosis and may bring greater initial gains than the presently used percutaneous transluminal angioplasty (PTA), researchers from the Wakayama Medical College of Wakayama, Japan note. At the 39th Meeting of the American Society of Neuroradiology (ASNR) in Boston, Massachusetts, Dr. Temoaki Terada and colleagues presented results from a Japanese study of 45 cases of intracranial atherosclerotic stenosis. Twenty-eight cases were intracranial internal carotid stenosis; seven were middle cerebral arterial stenosis; and ten were vertebrobasilar stenosis. In this study, 35 cases were treated with PTA alone. The other ten cases were treated with stenting, which was performed for the unsuccessful PTA cases. Forty-four of the 45 cases were successfully dilated. In one case, a PTA balloon catheter was not introduced into the lesion, according to Dr. Terada, "because of the torturous internal carotid artery." The indication of treatment in these cases was symptomatic stenosis greater than 70 percent for intracranial intradural lesions, and stenosis greater than 60 percent for intracranial extradural lesions. The stenosis improved from 83 percent to 28 percent in the PTA group, while the improvements were from 78 percent to 7 percent in the stent group. The restenosis rate of PTA and stenting was 21 percent and 14 percent, respectively. Overall morbidity/mortality was 9.4 percent in this study (one fatal hyperperfusion hemorrhage; one subarachnoid hemorrhage from the associated aneurysm; two ischemic complications resulting in minor neurologic deficits). The stent cases demonstrated greater initial gains compared to those in the PTA group, however, complications related to the stenting did occur. One stent migration required retrieval with a snare; one patient experienced restenosis; and one experienced thrombosis, requiring emergent thrombolysis treatment. E-mail this page to a friend or colleague! To print, use this version