Follow-up Evaluation of Dissection Caused by Percutaneous Transluminal Angioplasty for Intracranial Vascular Stenosis

Abstract

Percutaneous transluminal angioplasty (PTA) is a common method for severe intracranial artery stenosis treatment. Vascular dissection is a common complication of PTA, and its risks cannot be completely avoided. This study discusses the follow-up evaluations of PTA-induced dissections. We identified 11 dissected lesions (13.4%) among the 82 lesions for which PTA was performed to treat symptomatic intracranial artery stenosis in our hospital between April 2012 and March 2019. Of the dissected lesions, three (3.7%) were accompanied by symptomatic events and remaining eight lesions were asymptomatic.In the aforementioned three lesions, vessel flow improved in two lesions, but fresh infarctions were apparent in the perforator area. Another lesion showed symptomatic occlusion. In the 10 non-occluded dissected lesions, stents were used for the rescue of two dissected lesions in the acute phase, neither of which showed restenosis for at least half a year.In contrast, we observed remnant flow in eight lesions. Seven lesions showed no restenosis; however, one lesion required additional therapy for restenosis within half a year. These results suggest that the dissected lesions of the intracranial arteries caused by PTA showing the preservation of the true lumen with normal flow might be successfully managed with medical treatment alone. Stents may be useful for rescue from severely dissected stenosis with flow reduction.