FOLLOW-UP-STUDY AFTER INTRACRANIAL PERCUTANEOUS TRANSLUMINAL CEREBRALBALLOON ANGIOPLASTY

BACKGROUND AND PURPOSE: Our objective was to find the specific angiogr aphic characteristics of atherosclerotic lesions that indicate suitabi lity for intracranial percutaneous transluminal cerebral balloon angio plasty (PTCBA). METHODS: Forty-two clinically symptomatic patients wit h 42 hemodynamically significant intracranial lesions (>70% stenosis) were treated by PTCBA between January 1992 and May 1996. Before treatm ent, the patients were assigned to three groups according to the angio graphic characteristics of the lesions, as follows: type A, short (5 m m or less in length) concentric or moderately eccentric lesions less t han totally occlusive; type B, tubular (5 to 10 mm in length), extreme ly 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 wer e followed up for a period of 1 month to 6 years to compare the result s of PTCBA treatment among the three groups. Primary end points were d eath, stroke, or bypass surgery. RESULTS: The clinical success rates f or the type A, B, and C groups were 92%, 86%, and 33%, respectively. C umulative risks of fatal or nonfatal ischemic stroke or ipsilateral by pass surgery in type A, B, and C groups,were 8%, 26%, and 87%, respect ively. The cumulative risk of 8% among patients in the type A group ap peared to be smaller than in studies reported in the literature. CONCL USION: PTCBA for intracranial simple (type A) lesions yields a favorab le clinical outcome for symptomatic patients.