RT Journal Article
SR Electronic
T1 Techniques for Intracranial Stent Navigation in Patients with Tortuous Vessels
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1375
OP 1380
VO 26
IS 6
A1 Lee, Tae Hong
A1 Choi, Chang Hwa
A1 Park, Kyung-Pil
A1 Sung, Sang Min
A1 Lee, Sang Won
A1 Lee, Byung-Hee
A1 Kim, Dong Hyun
A1 Kim, Hak Jin
A1 Kim, Chang Won
A1 Kim, Suk
YR 2005
UL http://www.ajnr.org/content/26/6/1375.abstract
AB BACKGROUND AND PURPOSE: In some patients with stenosis of an intracranial artery, navigating the balloon or stent-delivery system is difficult of tortuous anatomy of the aortic arch, carotid arteries, or vertebral arteries Our purpose was to describe techniques of intracranial stent placement that help in navigating the stent-delivery system in tortuous vessels.METHODS: Between May 1998 and June 2004, 73 symptomatic stenotic (>50%) intracranial arteries were successfully treated with stent-assisted angioplasty. In 11 cases, standard techniques of navigating the stent-delivery system into the intended lesion failed because of vascular tortuosity. In these difficult cases, several techniques were used to overcome the tortuosity. Five lesions were located in the middle cerebral arteries, four were in the supraclinoid internal carotid arteries, and two were in the distal vertebral arteries.RESULTS: In all difficult cases, stents were successfully placed in the intracranial artery by using several techniques: 1) waiting method in which we waited for 20–30 minutes after advancement of the microwire across the lesion, 2) the double-wire technique, and 3) the coaxial double–guiding catheter technique. The waiting method made smooth stent navigation possible in five cases, the double-wire technique was successful in four cases, and the coaxial double–guiding catheter technique was effective in two cases. No technique-related complications occurred.CONCLUSION: In difficult cases in which standard techniques of navigating the stent-delivery system into the intended lesion fail because of vascular tortuosity, our techniques were useful methods for intracranial stent navigation.