RESUMO
BACKGROUND: A CTO of the intracranial ICA is usually managed medically and rarely by EC-IC bypass in selected patients. Percutaneous transluminal angioplasty has not been used. CASE DESCRIPTION: A 73-year-old man presented with frequent temporary blindness of the left eye and dizziness due to thrombotic occlusion of the left intracranial ICA, causing hemodynamic compromise. This patient was successfully treated by percutaneous angioplasty (balloon angioplasty and stent placement) under proximal balloon protection at 7 weeks from the ictus. Ischemic symptoms had not recurred during the 6-month follow-up period. CONCLUSION: Percutaneous angioplasty for a CTO of the intracranial ICA is technically feasible and can be an alternative to EC-IC bypass in a selected group of patients with symptomatic hemodynamic compromise, which is refractory to the best medical treatment.
Assuntos
Angioplastia com Balão/métodos , Artéria Carótida Interna/cirurgia , Estenose das Carótidas/cirurgia , Stents/tendências , Idoso , Angioplastia com Balão/instrumentação , Angioplastia com Balão/tendências , Cegueira/etiologia , Cegueira/fisiopatologia , Artéria Carótida Interna/diagnóstico por imagem , Artéria Carótida Interna/patologia , Estenose das Carótidas/diagnóstico por imagem , Estenose das Carótidas/patologia , Angiografia Cerebral , Revascularização Cerebral/normas , Circulação Cerebrovascular/fisiologia , Doença Crônica , Tontura/etiologia , Tontura/fisiopatologia , Humanos , Masculino , Medição de Risco , Stents/normas , Stents/estatística & dados numéricos , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
We report a 13-year-old boy who presented with acute basilar artery occlusion due to traumatic arterial dissection. Because a grave prognosis was expected if left untreated, and the chance of neurological recovery was believed to be unlikely but not zero, given that emergency stenting for the dissection was performed within 6 h of ictus. Recanalization of the basilar artery with stent placement did not change the poor prognosis in this patient because there was extension of dissection into the posterior cerebral arteries.