Recanalization of atherosclerotic stenosis and occlusion of intracranial vertebrobasilar artery
Intracranial vertebrobasilar atherosclerosis is one of the major causes of posterior circulation ischemic strokes and may result in a high risk of recurrent stroke. Current treatment for vertebrobasilar stenosis comprises aggressive medication and percutaneous transluminal angioplasty and stenting (...
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Elsevier
2025-06-01
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| Series: | IBRO Neuroscience Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667242124001246 |
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| author | Zhi-Long Zhou Liang-Fu Zhu Tian-Xiao Li Bu-Lang Gao |
| author_facet | Zhi-Long Zhou Liang-Fu Zhu Tian-Xiao Li Bu-Lang Gao |
| author_sort | Zhi-Long Zhou |
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| description | Intracranial vertebrobasilar atherosclerosis is one of the major causes of posterior circulation ischemic strokes and may result in a high risk of recurrent stroke. Current treatment for vertebrobasilar stenosis comprises aggressive medication and percutaneous transluminal angioplasty and stenting (PTAS). Endarterectomy and intracranial-extracranial bypass surgery may be considered for large artery stenosis in the anterior circulation, but they may be deterred by some technical difficulties and great complication rates in the vertebrobasilar stenoses. PTAS may be good for eliminating the arterial stenosis and preventing recoil of arterial wall after balloon angioplasty alone, however, higher peri-procedural complications and poor follow-up outcomes prevent PTAS as a common treatment strategy. Nonetheless, for selected patients with severe (≥70 %) stenosis and non-acute occlusion of the intracranial vertebrobasilar artery refractory to the best medication, PTAS may be feasible, safe and effective if the treatment approaches and endovascular devices were tailored to the clinic-radiological features of each lesion and patient. Sub-satisfactory stenting recanalization of the stenosis using a balloon < 80 % of the diameter of the nearby normal artery for dilatation of the stenosis and selection of softer and more flexible stents and delivery systems may be advantageous in decreasing the peri-procedural complications. This study reviewed the concept of intracranial vertebrobasilar atherosclerotic stenosis, available treatment modalities, peri-procedural complications, risk factors for endovascular treatment and prognosis, evidence for sub-satisfactory recanalization of the stenosis, and strategies to improve the peri-procedural complications and prognosis with the hope of improving the treatment outcome of endovascular recanalization. |
| format | Article |
| id | doaj-art-a45205bb11e04b75be20e26839674516 |
| institution | Kabale University |
| issn | 2667-2421 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
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| series | IBRO Neuroscience Reports |
| spelling | doaj-art-a45205bb11e04b75be20e268396745162025-01-05T04:28:49ZengElsevierIBRO Neuroscience Reports2667-24212025-06-01188895Recanalization of atherosclerotic stenosis and occlusion of intracranial vertebrobasilar arteryZhi-Long Zhou0Liang-Fu Zhu1Tian-Xiao Li2Bu-Lang Gao3Stroke Center, People's Hospital of Zhengzhou University, Henan Provincial People’s Hospital, School of Clinical Medicine, Henan University, 7 Weiwu Road, Zhengzhou, Henan 450003, ChinaCorresponding authors.; Stroke Center, People's Hospital of Zhengzhou University, Henan Provincial People’s Hospital, School of Clinical Medicine, Henan University, 7 Weiwu Road, Zhengzhou, Henan 450003, ChinaCorresponding authors.; Stroke Center, People's Hospital of Zhengzhou University, Henan Provincial People’s Hospital, School of Clinical Medicine, Henan University, 7 Weiwu Road, Zhengzhou, Henan 450003, ChinaStroke Center, People's Hospital of Zhengzhou University, Henan Provincial People’s Hospital, School of Clinical Medicine, Henan University, 7 Weiwu Road, Zhengzhou, Henan 450003, ChinaIntracranial vertebrobasilar atherosclerosis is one of the major causes of posterior circulation ischemic strokes and may result in a high risk of recurrent stroke. Current treatment for vertebrobasilar stenosis comprises aggressive medication and percutaneous transluminal angioplasty and stenting (PTAS). Endarterectomy and intracranial-extracranial bypass surgery may be considered for large artery stenosis in the anterior circulation, but they may be deterred by some technical difficulties and great complication rates in the vertebrobasilar stenoses. PTAS may be good for eliminating the arterial stenosis and preventing recoil of arterial wall after balloon angioplasty alone, however, higher peri-procedural complications and poor follow-up outcomes prevent PTAS as a common treatment strategy. Nonetheless, for selected patients with severe (≥70 %) stenosis and non-acute occlusion of the intracranial vertebrobasilar artery refractory to the best medication, PTAS may be feasible, safe and effective if the treatment approaches and endovascular devices were tailored to the clinic-radiological features of each lesion and patient. Sub-satisfactory stenting recanalization of the stenosis using a balloon < 80 % of the diameter of the nearby normal artery for dilatation of the stenosis and selection of softer and more flexible stents and delivery systems may be advantageous in decreasing the peri-procedural complications. This study reviewed the concept of intracranial vertebrobasilar atherosclerotic stenosis, available treatment modalities, peri-procedural complications, risk factors for endovascular treatment and prognosis, evidence for sub-satisfactory recanalization of the stenosis, and strategies to improve the peri-procedural complications and prognosis with the hope of improving the treatment outcome of endovascular recanalization.http://www.sciencedirect.com/science/article/pii/S2667242124001246Intracranial vertebrobasilar atherosclerotic stenosisPosterior circulationEndovascular recanalizationAngioplastyStenting |
| spellingShingle | Zhi-Long Zhou Liang-Fu Zhu Tian-Xiao Li Bu-Lang Gao Recanalization of atherosclerotic stenosis and occlusion of intracranial vertebrobasilar artery IBRO Neuroscience Reports Intracranial vertebrobasilar atherosclerotic stenosis Posterior circulation Endovascular recanalization Angioplasty Stenting |
| title | Recanalization of atherosclerotic stenosis and occlusion of intracranial vertebrobasilar artery |
| title_full | Recanalization of atherosclerotic stenosis and occlusion of intracranial vertebrobasilar artery |
| title_fullStr | Recanalization of atherosclerotic stenosis and occlusion of intracranial vertebrobasilar artery |
| title_full_unstemmed | Recanalization of atherosclerotic stenosis and occlusion of intracranial vertebrobasilar artery |
| title_short | Recanalization of atherosclerotic stenosis and occlusion of intracranial vertebrobasilar artery |
| title_sort | recanalization of atherosclerotic stenosis and occlusion of intracranial vertebrobasilar artery |
| topic | Intracranial vertebrobasilar atherosclerotic stenosis Posterior circulation Endovascular recanalization Angioplasty Stenting |
| url | http://www.sciencedirect.com/science/article/pii/S2667242124001246 |
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