Provisional stenting for symptomatic intracranial stenosis using a multidisciplinary approach: Acute results, unexpected benefit, and one-year outcome

Percutaneous techniques have dramatically changed our approach to coronary and peripheral revascularization. Intracranial atherosclerosis is a highly morbid disease; however, techniques for revascularization are still in evol ution. The authors comprise a multidisciplinary team of neurologists, neuro radiologists, and interventional cardiologists who have collaborated in tre ating fifteen patients with symptomatic intracranial stenosis who have fail ed medical therapy. The acute success rate (100%) acid one-year freedom fro m death and stroke (93.4%) using balloon angioplasty and provisional stenti ng are encouraging. A surprising observation in this patient cohort was tha t 53% of patients had improvement or resolution of a deficit that was chron ic and presumed to be permanent and irreversible. This type of chronic but reversible deficit is termed "brain angina". The background, rationale for a multidisciplinary team, techniques, and preliminary results of intracrani al angioplasty with provisional stenting are presented. (C) 2001 Wiley-Liss , Inc.