Perforating artery occlusion occurring after stent implantation of middle segment of basilar artery: a clinical study

Objective: To investigate the influence of stent implantation of middle basilar artery on the formation of perforating artery occlusion in order to provide effective means to improve clinical outcomes. Methods Wingspan stent implantation was carried out in 26 patients with symptomatic middle basilar artery stenosis. The technical success rate, the changes of arterial stenotic degree, the complications in perioperative period and the improvement of symptoms were determined, and the results were retrospectively analyzed. Results: A total of 27 Wingspan stents were used in 26 patients, with a technical success rate of 100%. Angiography performed immediate after the stenting showed that the stenosis ratio decreased from preoperative (78.8 ± 7.5)% to postoperative (23.1 ± 7.4)%. During perioperative period, complications occurred in two patients, and perforating artery occlusion was clinically suspected in the two patients. According to Malek scoring, the prognosis at 24 hours and one month after the procedure was evaluated. The prognosis score within 24 hours was one point in 25 cases and 4 points in one case, who died from pulmonary infection two weeks after the operation. All patients were followed up for 6-21 months, and the prognosis score was 1 point in 22 cases, 3 points in one case, 5 points in 2 cases. One patient died of intracerebral hemorrhage 7 months after the procedure. One case was lost in touch. Conclusion: For symptomatic middle basilar artery stenosis, Wingspan stent implantation can effectively prevent perforating artery occlusion. Initial results indicate that this technique came excellent and satisfactory clinical efficacy, although large randomized controlled studies are needed to further confirm the result. (authors)