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Angioplasty for basilar artery atherosclerosis

Case report

Arvind Ahuja, Lee R. Guterman, and Leo N. Hopkins

P ercutaneous transluminal angioplasty is being used successfully to treat atherosclerosis of the coronary, subclavian, vertebral, and peripheral arteries. However, there are few reports on the use of this procedure to treat disease of the basilar artery because of the technological limitations involved and the initially discouraging results. 5, 9, 10 We present a symptomatic case of atherosclerotic basilar artery stenosis treated successfully by angioplasty with a dilatation catheter system. This investigational system, * unlike earlier devices, employs a

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The sympathetic nervous system and atherosclerosis

Terry Lichtor, Harry R. Davis, Lydia Johns, Draga Vesselinovitch, Robert W. Wissler, and Sean Mullan

T he major risk factors for coronary atherosclerosis are hyperlipidemia, smoking, and hypertension. Behavioral factors have also been implicated in both human and nonhuman primate studies. 22 Among behavioral factors of potential importance in humans, the well-described coronary-prone behavior pattern has attracted considerable interest and has also been the subject of extensive epidemiological investigation. 16, 30 The classical coronary-prone (Type A) individual responds to his environment with a sense of time urgency, intense competitiveness, and poorly

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Current endovascular treatment options for intracranial carotid artery atherosclerosis

Ricardo J. Komotar, J Mocco, David A. Wilson, E. Sander Connolly Jr., Sean D. Lavine, and Philip M. Meyers

A substantial number of strokes are caused by intracranial atherosclerosis, a disease that traditionally has been treated medically. Recent technological advancements, however, have revolutionized the treatment of this condition by enabling the use of endovascular methods. In this paper the authors focus on the internal carotid artery, and review relevant studies concerning angioplasty with stent placement for the management of intracranial atherosclerosis in this vessel. With continued experience and a multidisciplinary approach in the evaluation of these patients, favorable outcomes may be achieved.

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Stent-assisted angioplasty of intracranial vertebrobasilar atherosclerosis: an initial experience

Peter A. Rasmussen, John Perl II, John D. Barr, Georges Z. Markarian, Irene Katzan, Cathy Sila, Derk Krieger, Anthony J. Furlan, and Thomas J. Masaryk

durability of treatment remain to be defined and surely will be influenced by future technological advances in catheter, balloon, and stent design. References 1. Ahuja A , Guterman LR , Hopkins LN : Angioplasty for basilar artery atherosclerosis. Case report. J Neurosurg 77 : 941 – 944 , 1992 Ahuja A, Guterman LR, Hopkins LN: Angioplasty for basilar artery atherosclerosis. Case report. J Neurosurg 77: 941–944, 1992 10.3171/jns.1992.77.6.0941 2. Callahan AS III , Berger BL : Balloon angioplasty of intracranial arteries for stroke prevention. J

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Development and internal-external validation of the ATHE Scale: predicting acute large vessel occlusion due to underlying intracranial atherosclerosis prior to endovascular treatment

Wang Chen, Ji Liu, Lei Yang, Hongyang Sun, Shuna Yang, Mengen Wang, Wei Qin, Yang Wang, Xianjun Wang, and Wenli Hu

E ndovascular treatment (EVT) is universally recommended as the primary therapy for acute ischemic strokes caused by intracranial anterior circulation large vessel occlusion (LVO). This recommendation is endorsed by various stroke and interventional societies. 1 – 4 In Asia, as demonstrated by a recent nationwide survey from China, a study revealed that 77.9% of patients undergoing EVT had anterior circulation LVO. Of these patients, 29% had occlusions attributable to intracranial atherosclerosis (ICAS). 5 In treating ICAS-LVO, it is important to

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Superior performance of cone-beam CT angiography in characterization of intracranial atherosclerosis

Clinical article

Mina G. Safain, Jason P. Rahal, Samir Patel, Alexandra Lauric, Edward Feldmann, and Adel M. Malek

KR , Kaufmann TJ , Morris JM , Lanzino G , Kallmes DF , : 3D C-arm conebeam CT angiography as an adjunct in the precise anatomic characterization of spinal dural arteriovenous fistulas . AJNR Am J Neuroradiol 31 : 476 – 480 , 2010 10.3174/ajnr.A1840 2 Arenillas J , Wong K , Caplan L : Natural Course and Prognosis . Intracranial Atherosclerosis Chichester, West Sussex , Blackwell , 113 – 124 , 2008 3 Arenillas JF : Intracranial atherosclerosis: current concepts . Stroke 42 : 1 Suppl S20 – S23 , 2011 4 Carvalho M

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The effect of atherosclerosis on endothelium-dependent relaxation in the aorta and intracranial arteries of rabbits

Kenji Kanamaru, Shiro Waga, Hiroshi Tochio, and Kazuhiko Nagatani

C linical and experimental observations suggest that atherosclerosis alters vascular reactivity. 7 The cerebral circulation seems more resistant to the development of atherosclerotic lesions than other vascular beds; 11 however, lipoprotein abnormalities are correlated with stroke, cerebral infarction, and transient ischemic attacks (TIA's). 14 Dramatic reversal of TIA dysfunction by limiting the amount of dietary cholesterol has been described. 4 Few animal studies of the cerebral circulation have focused on hypercholesterolemia or atherosclerosis

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Cerebral aneurysms and accelerated atherosclerosis in Russell-Silver syndrome: a new subtype? Case report

Heinke Pülhorn, Jonathan Pesic-Smith, Peter Cowley, and Mary Murphy

, 3 , 4 and at least 44% of patients with RSS show hypomethylation in the chromosome 11p15 imprinting control region 1. 5 Furthermore, a small number of reports of autosomal dominant transmission including ring 2 chromosome, balanced translocation of 17q25, and duplication of band 7p11.2-p13 have been published. 3 Genetic testing for the syndrome is in development, 4 but the pathophysiological mechanisms resulting in the RSS phenotype remain unknown. We report on an unusual case of widespread accelerated atherosclerosis and multiple cerebral aneurysms in a

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Applications of stenting for intracranial atherosclerosis

Dale Ding and Kenneth C. Liu

S troke is one of the leading causes of morbidity and mortality in the US population, 3 and along with TIAs, afflicts approximately 900,000 people annually. 18 Intracranial atherosclerosis comprises 70,000–90,000 of these cases. 26 While medical therapy with aspirin has been shown to be safe and effective in treating symptomatic intracranial arterial stenosis in more than 50% of cases, 4 the rate of recurrent ischemic stroke ipsilateral to the stenotic artery is still approximately 12% at 1-year follow-up. Unfortunately, surgery has, to date, not shown

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The critical role of hemodynamics in the development of cerebral vascular disease

A review

Alexander M. Nixon, Murat Gunel, and Bauer E. Sumpio

R esearch over the past few decades has identified numerous risk factors predisposing patients to vascular diseases such as atherosclerosis and saccular aneurysm formation. Factors that are common to both disorders include smoking, hypertension, and familial predisposition. 63 , 131 Because the entire vasculature is exposed to the same potentially harmful influences, it might be expected that pathological lesions would be seen in a random distribution throughout the arterial tree. In reality the distribution of such lesions proves to be far from random, and