Perioperative and 90-day Clinical and Radiological Results of Endovascular Treatment of Symptomatic Basilar Artery Stenosis.

Objective: The aim of our study is to evaluate the safety and effectiveness of basilar artery stenosis cases in which we applied endovascular treatment due to recurrent stroke under optimal medical management. Methods: Patients with severe basilar artery stenosis (70-99%) due to atherosclerosis, who had transient ischemic attack or ischemic stroke despite optimal medical management, and who underwent endovascular treatment were retrospectively examined. The primary outcomes were ischemic or hemorrhagic stroke within 90 days after stent deployment and death related to the endovascular procedure during hospitalization. Secondary outcomes were successful revascularization (residual stenosis <30%) and procedure-related complications. Results: The median age of the 19 patients included in the study was 65 years (IQR, 53-68.5), and 74% were male. The most common area of stenosis was the proximal third of the basilar artery (63%), followed by the middle third (37%). According to the Mori classification, the most common lesion type was MORI A (53%), followed by MORI B (42%). While the stenosis rate before endovascular treatment was 85% (IQR, 80-90%), the median residual stenosis rate after successful stenting was 16% (IQR, 11-20). Treatment was successful in 18 of 19 patients (95%), and only 1 patient died due to basilar artery perforation during the procedure. The mortality rate was 5% (1/19). Asymptomatic stent restenosis was observed in one patient who underwent balloon angioplasty. During this period, no recurrent ischemic stroke was observed in any patient. The 3rd month mRS score was 1 (IQR, 0-1.5). Conclusion: The endovascular treatment of basilar artery stenosis appears to be safe and effective in experienced centers, despite the potential risk of perioperative complications. Randomized controlled trials are necessary to validate the efficacy and safety outcomes of balloon angioplasty and stenting. [ABSTRACT FROM AUTHOR]