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Minimally Invasive Surgery
Volume 2014, Article ID 949585, 6 pages
Clinical Study

Endovascular Recanalization for Chronic Symptomatic Intracranial Vertebral Artery Total Occlusion

1Department of Neurology, The First Affiliated Hospital of College of Medicine, Zhejiang University, No. 79 QingChun Road, Hangzhou, Zhejiang 310003, China
2Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Beijing 100050, China
3Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong
4Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China

Received 12 January 2014; Accepted 29 May 2014; Published 3 September 2014

Academic Editor: Steve Ramcharitar

Copyright © 2014 Ziqi Xu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. The outcome of recanalization in patients with chronic symptomatic intracranial vertebral artery (ICVA) total occlusion is poor. This paper reports the technical feasibility and long-term outcome of ICVA stenting in patients with chronic symptomatic total occlusion. Methods. Retrospective review of our prospectively maintained intracranial intervention database to identify patients with symptomatic total occlusion of ICVA with revascularization attempted >1 month after index ischemic event. Results. Eight patients (mean age 58 years) were identified. One had stroke and 7 had recurrent transient ischemic attacks. Four had bilateral ICVA total occlusion and 4 had unilateral ICVA total occlusion with severe stenosis contralaterally. Seven of 8 patients underwent endovascular recanalization, which was achieved in 6. Periprocedural complications included cerebellum hemorrhage, arterial dissection, perforation, and subacute in-stent thrombosis which occurred in 3 patients. One patient died of cerebellum hemorrhage. The other patients improved clinically after endovascular therapy. Conclusions. Stent-supported recanalization of ICVA total occlusion is technically feasible, and may become a viable treatment option in selected patients.