Endovascular Treatment of Basilar Artery Stenosis

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Objective To analyze epidemiological characteristics and therapeutic evolution of patients with basilar artery (BA) stenosis who underwent endovascular therapy in a reference service.

Methods Observational retrospective study of a case report of individuals with BA stenosis who underwent endovascular therapy in an endovascular neurosurgery reference service, between November 2005 and May 2018.

Results The prevalence was higher among male patients, with 60% of the cases. As for age, it ranged from 18 to 81 years old, with a mean of 60.2 years old. In terms of comorbidities, systemic arterial hypertension was found in 93% of the patients, and dyslipidemia in 86.7%. The initial symptoms were previous history of ischemic cerebrovascular accident (CVA) in 43.3% of the cases and dizziness in 46.7%. The degree of stenosis ranged from 90 to a 98% of obstruction, with a mean of 92.8%. Neurological deficit was observed in 23.3% of the cases postoperatively, and the postoperative death rate was 10% (3/30). There were no intraoperative adverse events.

Conclusion The applicability of endovascular stenting therapy in high-grade BA stenosis proved to be a safe and effective technique with lower morbimortality rates and faster recovery.

Resumo

Objetivo Analisar as características epidemiológicas e a evolução terapêutica de pacientes com estenose de artéria basilar (AB) submetidos a terapia endovascular em serviço de referência.

Metodologia Estudo retrospectivo observacional de trinta pacientes com estenose de AB submetidos à terapia endovascular em serviço de referência em neurocirurgia endovascular de Blumenau, SC, Brasil, no período de novembro de 2005 a maio de 2018.

Resultados O sexo masculino foi o mais prevalente, com 60% dos casos. A idade variou de 18 a 81 anos, sendo a média de 60,2 anos. Quanto à presença de comorbidades, observou-se que a hipertensão arterial sistêmica esteve presente em 93% dos casos e a dislipidemia em 86,7% dos casos. As sintomatologias iniciais observadas foram história prévia de AVE isquêmico em 43,3% dos casos e tontura em 46,7%. O grau de estenose variou de 90 a 98% de obstrução, com a média de 92,8%. Os stents de balão expansíveis foram os mais utilizados, sendo o da marca Pro-Kinect Energy o mais utilizado (60%). Por fim, em 23,3% dos casos, observou-se déficit neurológico no pós-operatório, e a taxa de óbito foi de 10% (3/30) no pós-operatório. Não ocorreu nenhum evento adverso intraoperatório.

Conclusão A aplicabilidade da terapia endovascular com utilização de stent em quadros de alto grau de estenose de AB mostrou-se técnica segura e eficaz com menores taxas de morbimortalidade e recuperação mais rápida.

Keywords basilar artery - stenosis - dizziness - endovascular - case report Palavras-chave artéria basilar - estenose - tontura - endovascular - angioplastia Ethics Approval

Ethical approval for the present study was obtained from the Comitê de Ética na Pesquisa em Seres Humanos of FURB, under CAAE: 80423017.7.0000.5370.


Disclosures

No potential conflict of interests relevant to this article was reported.

Publication History

Received: 20 March 2023

Accepted: 21 June 2023

Article published online:
31 October 2023

© 2023. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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