Acute Stroke Patients

BACKGROUND AND PURPOSE: The clinical outcome is often poor in acute stroke patients with a serious neurological status due to occlusive lesions of the intracranial vertebral and/or basilar artery (IVBA). The purpose of this study was to investigate retrospectively the clinical features and outcome of acute stroke patients who underwent transluminal angioplasty and/or stenting (TAS) for occlusive lesions of the IVBA and to clarify the prerequisites for improvement of outcome. MATERIALS AND METHODS: Of 1690 consecutive acute ischemic stroke patients admitted to our institution, TAS for occlusive lesions of the IVBA was performed within 7 days after stroke onset in 28 patients. We classified these patients into 2 groups, those with total occlusion (occlusion group) and those with a high-grade stenosis (stenosis group), and compared the preprocedural neurologic status (severe: National Institutes of Health Stroke Scale 20), the rate of technical success, major proce-dure-related complications, subacute occlusion of the treated vessel, and favorable clinical outcome (0-2 points on a 3-month modified Rankin Scale) between the 2 groups. RESULTS: In the occlusion group (n 16) and stenosis group (n 12), a severe preprocedural neurologic status was seen in 13 and 1 patients, respectively (81 % versus 8%; P .0001); technical success was achieved in 13 and 11 patients, respectively (81 % versus 92%; P value not significan