[Endovascular treatment of critical basilar stenosis with a Solitaire® stent device: a first experience in our centre]

Rev Neurol. 2014 Aug 1;59(3):118-20.
[Article in Spanish]

Abstract

Introduction: Although intracranial arteriosclerosis is an important cause of stroke, the therapeutic attitude has still not been clearly established. Hence, the SAMMPRIS study compared intensive medical treatment with angioplasty and stent placement, with outcomes favouring the pharmacological treatment. These results could be partly due to the device used (Wingspan® stent).

Case report: A 71-year-old male with a severe stenosis of the basilar artery, who suffered repeated episodes of transient neurological focus despite being treated with antiplatelet therapy and statins. Given the circumstances, the decision was made to perform a therapeutic arteriography with angioplasty and placement of a Solitaire® stent in order to optimise results, a residual stenosis of 40% being achieved. Subsequent progress was favourable and the control tests carried out showed a minimum progression.

Conclusions: As far as we know, this is the first case of critical stenosis of the basilar artery being treated by placement of a Solitaire® stent to be reported in the literature.

Title: Tratamiento endovascular de una estenosis critica basilar con dispositivo stent Solitaire ®: primera experiencia en nuestro centro.

Introduccion. Aunque la arterioesclerosis intracraneal es una causa importante de ictus, la actitud terapeutica no esta claramente establecida. En este sentido, el estudio SAMMPRIS comparo el tratamiento medico intensivo con la angioplastia y colocacion de stent, con resultados favorables al tratamiento farmacologico. Estos resultados podrian, en parte, deberse al dispositivo utilizado (stent Wingspan ®). Caso clinico. Varon de 71 años con una estenosis grave de la arteria basilar, en quien se repetian episodios de focalidad neurologica transitoria a pesar del tratamiento con doble antiagregacion y estatinas. En estas circunstancias se decidio realizar una arteriografia terapeutica con angioplastia y colocacion de un stent Solitaire ® para optimizar resultados y se logro una estenosis residual del 40%. La evolucion fue favorable y los controles posteriores muestran una minima progresion. Conclusion. Segun nuestro conocimiento, este es el primer caso publicado de tratamiento de una estenosis critica de la arteria basilar mediante la colocacion de un stent Solitaire ®.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angioplasty, Balloon*
  • Cerebral Angiography
  • Dyslipidemias / complications
  • Humans
  • Hypertension / complications
  • Imaging, Three-Dimensional
  • Ischemic Attack, Transient / etiology
  • Male
  • Stents*
  • Vertebrobasilar Insufficiency / complications
  • Vertebrobasilar Insufficiency / diagnostic imaging
  • Vertebrobasilar Insufficiency / therapy*