PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY FOR INTRACRANIAL ARTERIOSCLEROTIC LESIONS

We report 17 cases of intracranial arterial stenosis treated by percut aneous transluminal angioplasty (PTA), including 9 on the intracranial internal carotid (ICA), 4 on the middle cerebral (MCA), and 3 on vert ebrobasilar artery (VBA) system. All patients had ischaemic brain symp toms and stenoses of more than 60% (calculated angiographically). We t reated four patients by PTA for residual stenoses after thrombolysis f or acute occlusion. We used PTA balloon catheters 2.0-3.5 mm in diamet er for all procedures. As a rule, the balloon was inflated for 1 min a t 6 atm. All arteries were successfully dilated (stenosis less than 50 %) except for one treated by PTA for residual MCA stenosis after throm bolysis. The patient died of a massive infarct due to MCA reocclusion caused by arterial dissection. Stenosis recurred in 3 of 16 patients. Repeat PTA was successfully carried out in these cases. However, steno sis recurred in one of these patients 3 months after PTA, but the pati ent is being followed because he is asymptomatic. PTA of intracranial arteries is effective, but its indications should be based strictly on potential risks, such as acute occlusion derived from arterial dissec tion.