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Figure 5 Basilar Artery Stenting for Lightheadedness
A 78-year-old woman presented with episodic lightheadedness, and a complete work-up including magnetic resonance angiography (MRA) of the brain suggested a high-grade stenosis of the basilar artery (BA). (A) Intracerebral angiography confirms a high-grade proximal BA stenosis (arrow) of 95%. (B) After balloon dilation, <30% residual stenosis remains. She had difficulty with her balance and vision for 1 month after the procedure, but then her symptoms completely resolved. (C) Six months later with symptom recurrence, an MRA demonstrated restenosis of the BA, which is confirmed by intracerebral angiography. Note the hypoplastic left vertebral artery (LVA). (D) After placement of a 2.5 x 12 mm Taxus (Boston Scientific, Natick, Massachusetts) drug-eluting coronary stent (thick arrow), <20% residual stenosis remains, and the patient has had no further neurological events at 24-month follow-up. The hypoplastic LVA and the left inferior cerebellar artery (LICA) (thin arrows) both remain patent after stent placement across these vessels. LPCA = left posterior cerebral artery; RPCA = right posterior cerebral artery; RVA = right vertebral artery.
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