Comparison of safety and mid-term effects between direct stenting and angioplasty before stenting in the basilar artery.

OBJECTIVES

Symptomatic atherosclerotic disease of the basilar artery (BA) portends a poor prognosis, and BA seemed to be the most dangerous site for stenting. The authors review their interventional results and mid-term results with or without predilation in BA stenting to find a safer interventional approach.

PATIENTS AND METHOD

A database review identified 94 patients with severe symptomatic BA stenosis were treated with stenting. According to with balloon predilation or not, they were divided into two groups: direct stenting group and angioplasty before stenting group. Baseline data, lesion characteristics, complications and follow-up data from the two groups were compared and analyzed.

RESULTS

The length of lesion in angioplasty before stenting group was longer than that in the direct stenting group (8.12 ± 2.76 mm versus 6.83 ± 2.27 mm, p = 0.015). The proportions of Mori C type lesion was higher in angioplasty before stenting group (31.3 % versus 8.7 %, p = 0.006). The residual stenosis was higher in angioplasty before stenting group (12.66 ± 9.24 % versus 7.67 ± 8.01 %, p = 0.006). There were no significant differences in TIA, stroke, and death between the two groups in the perioperative and postoperative > 1 year follow-up (p > 0.05).

CONCLUSION

BA stenting is relatively safe and has a good results for experienced operators. Angioplasty before stenting is a good way for BA stenting, it makes the operations on difficult lesions as safe as normal one. More optimized stents and safer interventional approach need to be further explored and verified.