Phatouros C C, Higashida R T, Malek A M, Smith W S, Mully T W, DeArmond S J, Dowd C F, Halbach V V
Department of Radiology, University of California San Francisco Medical Center, 94143-0628, USA.
Neurosurgery. 1999 Mar;44(3):667-73. doi: 10.1097/00006123-199903000-00134.
The goal of this report was to describe the successful percutaneous endovascular use of a Gianturco-Roubin-2 coronary stent in the treatment of an acute atherothrombotic occlusion of the basilar artery. To our knowledge, the percutaneous endovascular deployment of an intra-arterial stent for the treatment of an acute atherothrombotic occlusion of the basilar artery and the percutaneous endovascular placement of a Gianturco-Roubin-2 stent in the basilar artery have not been previously reported.
An 83-year-old man presented with a recurrent, transient, locked-in syndrome resulting from a lower basilar artery occlusion caused by vertebrobasilar thrombosis superimposed on severe proximal basilar artery atheromatous stenosis.
After successful superselective intra-arterial thrombolysis of the vertebrobasilar clot, balloon angioplasty of the underlying basilar artery stenosis was performed, without significant angiographic improvement. Percutaneous endovascular deployment of a Gianturco-Roubin-2 coronary stent of 4-mm diameter was subsequently performed, with excellent angiographic results.
The patient made a very good neurological recovery but unfortunately died as a result of cardiogenic shock and sepsis. Detailed neuropathological follow-up results are presented; stent patency was revealed in the postmortem examination. The anatomic and pathophysiological considerations of basilar artery stent placement for the treatment of acute basilar artery occlusion related to atherosclerotic stenosis are discussed.
本报告的目的是描述在治疗基底动脉急性动脉粥样硬化血栓形成性闭塞中成功经皮血管内使用Gianturco-Roubin-2冠状动脉支架的情况。据我们所知，此前尚未报道过经皮血管内植入动脉支架治疗基底动脉急性动脉粥样硬化血栓形成性闭塞以及在基底动脉中经皮血管内放置Gianturco-Roubin-2支架的情况。
一名83岁男性因严重基底动脉近端动脉粥样硬化狭窄基础上的椎基底动脉血栓形成导致基底动脉下段闭塞，出现反复短暂的闭锁综合征。
成功对椎基底动脉血栓进行超选择性动脉内溶栓后，对基底动脉狭窄进行球囊血管成形术，但血管造影结果无明显改善。随后经皮血管内植入一枚直径4毫米的Gianturco-Roubin-2冠状动脉支架，血管造影结果极佳。
患者神经功能恢复良好，但不幸因心源性休克和脓毒症死亡。报告了详细的神经病理学随访结果；尸检显示支架通畅。讨论了放置基底动脉支架治疗与动脉粥样硬化狭窄相关的急性基底动脉闭塞的解剖学和病理生理学考虑因素。
